Provider Demographics
NPI:1023899374
Name:BELL, TAWANNA
Entity type:Individual
Prefix:
First Name:TAWANNA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 S PERRY ST STE 206
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4811
Mailing Address - Country:US
Mailing Address - Phone:855-368-6353
Mailing Address - Fax:855-368-6353
Practice Address - Street 1:113 S PERRY ST STE 206
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4811
Practice Address - Country:US
Practice Address - Phone:855-368-6353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246R00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Pathology