Provider Demographics
NPI:1881139897
Name:BELL, IESHA SHANAE (DNP)
Entity type:Individual
Prefix:DR
First Name:IESHA
Middle Name:SHANAE
Last Name:BELL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:IESHA
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:9318 STATE ROUTE 14
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-5224
Mailing Address - Country:US
Mailing Address - Phone:330-626-3111
Mailing Address - Fax:
Practice Address - Street 1:9318 STATE ROUTE 14
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-5224
Practice Address - Country:US
Practice Address - Phone:330-297-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF1016311363LF0000X
OHAPRN.CNP.026689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily