Provider Demographics
NPI:1912631045
Name:BELL, SAMANTHA TAYLOR (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:TAYLOR
Last Name:BELL
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WARREN ST APT B-1
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-6931
Mailing Address - Country:US
Mailing Address - Phone:315-766-3283
Mailing Address - Fax:
Practice Address - Street 1:24 NICHOLSVILLE RD
Practice Address - Street 2:
Practice Address - City:BERNHARDS BAY
Practice Address - State:NY
Practice Address - Zip Code:13028-3117
Practice Address - Country:US
Practice Address - Phone:315-766-3283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2363300163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical