Healthcare Provider Details

I. General information

NPI: 1245436252
Provider Name (Legal Business Name): MS. SUE P BELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 10/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 MACK RD SUITE 200
FAIRFIELD OH
45014-5379
US

IV. Provider business mailing address

3050 MACK RD SUITE 200
FAIRFIELD OH
45014-5379
US

V. Phone/Fax

Practice location:
  • Phone: 513-981-6784
  • Fax: 513-215-9397
Mailing address:
  • Phone: 513-981-6784
  • Fax: 513-215-9397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberRN.314438
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA08811NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: