MEDICARE: ALICIA GRACE BELL RDN, LDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian		AZ

General Provider Information

NPI Number	:	1558967364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA GRACE BELL RDN, LDN

Provider Business Mailing Address
First Line	:	4630 N PASEO AQUIMURI
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-1612
Country	:	US
Telephone Number	:	520-343-3495
Fax Number	:

Provider Business Practice Location Address
First Line	:	1132 W DICKENS AVE # 1R
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4135
Country	:	US
Telephone Number	:	520-343-3495
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2020
Last Update Date	:	06/20/2023

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