Provider Demographics
NPI:1962009720
Name:BELL, KIMBERLY CLAIRE (APRN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CLAIRE
Last Name:BELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 CORAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-3016
Mailing Address - Country:US
Mailing Address - Phone:912-275-8165
Mailing Address - Fax:912-289-9450
Practice Address - Street 1:4220 CORAL PARK DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-3016
Practice Address - Country:US
Practice Address - Phone:912-275-8165
Practice Address - Fax:912-289-9450
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN235380363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner