Healthcare Provider Details

I. General information

NPI: 1013483676
Provider Name (Legal Business Name): KATRINA BROOKSHIRE BELL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 CONNELLY SPRINGS RD
LENOIR NC
28645-7827
US

IV. Provider business mailing address

102 BRANDYWINE DR NE APT T4
CONOVER NC
28613-1783
US

V. Phone/Fax

Practice location:
  • Phone: 828-757-6300
  • Fax: 828-757-6324
Mailing address:
  • Phone: 828-851-0517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number253925
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5011154
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: