Provider Demographics
NPI:1720719693
Name:BELL, KRISSY LYNN
Entity Type:Individual
Prefix:
First Name:KRISSY
Middle Name:LYNN
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 1:340 CHEAT VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:WV
Mailing Address - Zip Code:26287-8005
Mailing Address - Country:US
Mailing Address - Phone:304-614-3755
Mailing Address - Fax:304-637-5606
Practice Address - Street 1:909 GORMAN AVE STE 6
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3100
Practice Address - Country:US
Practice Address - Phone:130-463-7363
Practice Address - Fax:304-637-5606
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV36720164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse