MEDICARE: MRS. DEBORAH BELL NUTRITIONIST

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	133N00000X	Nutritionist
2	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1316488042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH BELL NUTRITIONIST

Provider Business Mailing Address
First Line	:	462 ROYAL OAKS DR
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95687-5022
Country	:	US
Telephone Number	:	707-372-7106
Fax Number	:

Provider Business Practice Location Address
First Line	:	462 ROYAL OAKS DR
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95687-5022
Country	:	US
Telephone Number	:	707-372-7106
Fax Number	:

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

Provider Enumeration Date	:	03/14/2017
Last Update Date	:	03/14/2017

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