Provider Demographics
NPI:1881181634
Name:BELL, KISHANA RENEE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KISHANA
Middle Name:RENEE
Last Name:BELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KISHANA
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 27892
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2030
Mailing Address - Country:US
Mailing Address - Phone:901-758-9900
Mailing Address - Fax:901-752-2335
Practice Address - Street 1:1265 UNION AVE, 2 SHORB TOWER
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104
Practice Address - Country:US
Practice Address - Phone:901-478-5330
Practice Address - Fax:901-516-8358
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018038756363LF0000X
TN28959363L00000X
MO2010010674163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency