Healthcare Provider Details
I. General information
NPI: 1669732376
Provider Name (Legal Business Name): ASHLEY NICOLE BELL D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/29/2012
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1235 E CHEROKEE ST
SPRINGFIELD MO
65804-2203
US
IV. Provider business mailing address
1235 E CHEROKEE ST
SPRINGFIELD MO
65804-2203
US
V. Phone/Fax
- Phone: 417-820-8600
- Fax:
- Phone: 417-820-8600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | T086033011 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | E-8970 |
| License Number State | AR |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 2016032276 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: