Healthcare Provider Details

I. General information

NPI: 1851126106
Provider Name (Legal Business Name): NAKIARA BELL RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5354 ASHLEIGH RD
FAIRFAX VA
22030-7227
US

IV. Provider business mailing address

5354 ASHLEIGH RD
FAIRFAX VA
22030-7227
US

V. Phone/Fax

Practice location:
  • Phone: 571-289-1218
  • Fax:
Mailing address:
  • Phone: 571-289-1218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number0001274318
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-315180
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: