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General NPI Number Information
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NPI Number | 1710330733
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Entity Type | Individual
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Provider Name | IDA JUTTING BELL NP
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Gender | Female
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 1175 DUNLAWTON AVE STE 102
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City | PORT ORANGE
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State | FL
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Zip | 32127-4741
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Country | US
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Telephone | 386-316-8092
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Fax |
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Provider Business Mailing Address
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Address Line | 2580 PALM DR
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City | PORT ORANGE
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State | FL
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Zip | 32128-6557
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Country | US
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Telephone | 386-316-8092
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 200493
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 257346
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9257624
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License Number State | FL
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