Healthcare Provider Details

I. General information

NPI: 1538128640
Provider Name (Legal Business Name): BELLS FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 FRONT ST
BELLS TN
38006
US

IV. Provider business mailing address

103 FRONT STREET
BELLS TN
38006
US

V. Phone/Fax

Practice location:
  • Phone: 731-663-3794
  • Fax: 731-663-3737
Mailing address:
  • Phone: 731-663-3794
  • Fax: 731-663-3737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateTN

VIII. Authorized Official

Name: MS. ALICE JEANETTE WALDROP
Title or Position: PRESIDENT
Credential: FNP
Phone: 731-663-3794