Healthcare Provider Details

I. General information

NPI: 1881139897
Provider Name (Legal Business Name): IESHA SHANAE BELL DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IESHA SCOTT NP

II. Dates (important events)

Enumeration Date: 12/29/2016
Last Update Date: 12/24/2020
Certification Date: 12/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9318 STATE ROUTE 14
STREETSBORO OH
44241-5224
US

IV. Provider business mailing address

9318 STATE ROUTE 14
STREETSBORO OH
44241-5224
US

V. Phone/Fax

Practice location:
  • Phone: 330-297-0811
  • Fax:
Mailing address:
  • Phone: 330-626-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF1016311
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026689
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: