Provider Demographics
NPI:1891128310
Name:BELL, GLORIA JEAN (LICENSE NURSE)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:JEAN
Last Name:BELL
Suffix:
Gender:F
Credentials:LICENSE NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2715 COLONIAL DR
Mailing Address - Street 2:SUITE 200B
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6818
Mailing Address - Country:US
Mailing Address - Phone:803-898-8888
Mailing Address - Fax:803-898-0837
Practice Address - Street 1:2715 COLONIAL DR
Practice Address - Street 2:SUITE 200B
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6818
Practice Address - Country:US
Practice Address - Phone:803-898-8888
Practice Address - Fax:803-898-0837
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP38930164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse