MEDICARE: JENNA 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	163W00000X	Registered Nurse	4704340937	MI

General Provider Information

NPI Number	:	1417748757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA BELL

Provider Business Mailing Address
First Line	:	3190 BEACH RD
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-1768
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3190 BEACH RD
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-1768
Country	:	US
Telephone Number	:	313-408-5261
Fax Number	:

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

Provider Enumeration Date	:	05/15/2025
Last Update Date	:	05/15/2025

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Directions to “ JENNA BELL ” Practice Location

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