Provider Demographics
NPI:1740940790
Name:BLUEBELL HEALTH & WELLNESS, PLLC
Entity type:Organization
Organization Name:BLUEBELL HEALTH & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DNP, FNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZUREK
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC
Authorized Official - Phone:252-903-9974
Mailing Address - Street 1:3484 US HIGHWAY 13 S
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-1025
Mailing Address - Country:US
Mailing Address - Phone:919-689-2222
Mailing Address - Fax:
Practice Address - Street 1:3484 US HIGHWAY 13 S
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-1025
Practice Address - Country:US
Practice Address - Phone:919-689-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5011760OtherNURSE PRACTITIONER LICENSE NUMBER