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NPI Code Detail

MEDICARE: AARON ALLEN BELLOW JR. NP

MEDICARE:   AARON ALLEN BELLOW JR. NP
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
1363LF0000XFamily Nurse Practitioner647389TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2V111603OTHERNVSMA MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1205931656
Entity Type Code : Individual
Provider Name (Legal Business Name) : AARON ALLEN BELLOW JR. NP
Provider Business Mailing Address
First Line : PO BOX 15645
Second Line :
City : LAS VEGAS
State : NV
Zip : 89114-5645
Country : US
Telephone Number : 702-579-3298
Fax Number :
Provider Business Practice Location Address
First Line : 4475 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7826
Country : US
Telephone Number : 702-669-5840
Fax Number : 702-650-5729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 11/10/2015

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