Healthcare Provider Details

I. General information

NPI: 1770556946
Provider Name (Legal Business Name): JANE ELIZABETH BELL APRN NPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GEORGE E WHALEN VA MED CENTER (111P) 500 FOOTHILL BLVD
SALT LAKE CITY UT
84148-0001
US

IV. Provider business mailing address

3607 GOLDEN HILLS AVE
SALT LAKE CITY UT
84121-6169
US

V. Phone/Fax

Practice location:
  • Phone: 801-582-1565
  • Fax:
Mailing address:
  • Phone: 801-694-6959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number215186-8900
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: