Provider Demographics
NPI:1841408044
Name:BELL, MELODI G
Entity type:Individual
Prefix:MRS
First Name:MELODI
Middle Name:G
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MELODI
Other - Middle Name:G
Other - Last Name:NASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:63 RANDOLPH DR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-2827
Mailing Address - Country:US
Mailing Address - Phone:207-945-5312
Mailing Address - Fax:
Practice Address - Street 1:63 RANDOLPH DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-2827
Practice Address - Country:US
Practice Address - Phone:207-945-5312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS 18073747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider