MEDICARE: MRS. ALICIA BELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	256826	GA
2	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1205536752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA BELL

Provider Business Mailing Address
First Line	:	107 BELLINGTON DR
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-8676
Country	:	US
Telephone Number	:	404-883-7935
Fax Number	:

Provider Business Practice Location Address
First Line	:	3715 NORTHSIDE PKWY NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-2886
Country	:	US
Telephone Number	:	770-938-1757
Fax Number	:	770-938-1759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2023
Last Update Date	:	07/18/2024

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Directions to “ MRS. ALICIA BELL ” Practice Location

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