Provider Demographics
NPI:1356724108
Name:BELL, KIMBERLY C (NP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:C
Last Name:BELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 INTERSTATE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-2709
Mailing Address - Country:US
Mailing Address - Phone:931-210-5577
Mailing Address - Fax:931-210-5575
Practice Address - Street 1:1029 WATERFORD PL
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2686
Practice Address - Country:US
Practice Address - Phone:865-248-8874
Practice Address - Fax:865-270-2075
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN20100OtherAPN
TN188866OtherRN