Healthcare Provider Details

I. General information

NPI: 1477098846
Provider Name (Legal Business Name): SUSAN ELIZABETH BELL RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 ATHENS ST
GAINESVILLE GA
30507-7000
US

IV. Provider business mailing address

1290 ATHENS ST
GAINESVILLE GA
30507-7000
US

V. Phone/Fax

Practice location:
  • Phone: 770-718-5092
  • Fax: 770-535-5742
Mailing address:
  • Phone: 770-718-5092
  • Fax: 770-535-5742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN238839
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: