Healthcare Provider Details

I. General information

NPI: 1417121765
Provider Name (Legal Business Name): IMOGENE A BELL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 04/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 N MORLEY AVE
NOGALES AZ
85621-2930
US

IV. Provider business mailing address

480 N MORLEY AVE
NOGALES AZ
85621-2930
US

V. Phone/Fax

Practice location:
  • Phone: 520-287-2726
  • Fax: 520-287-6159
Mailing address:
  • Phone: 520-287-2726
  • Fax: 520-287-6159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberRN015488
License Number StateAZ

VIII. Authorized Official

Name: MRS. IMOGENE ADAIR BELL
Title or Position: OWNER
Credential: FNP
Phone: 520-287-2726