Provider Demographics
NPI:1255063012
Name:BELL, CHRISTOPHER MIKEL-EUGENE (FNP-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MIKEL-EUGENE
Last Name:BELL
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:100 MICHIGAN ST NE # MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2111 12 MILE RD NW
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:MI
Practice Address - Zip Code:49345-9754
Practice Address - Country:US
Practice Address - Phone:616-391-8470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704293293363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704293293OtherSTATE OF MICHIGAN