Basic Information
| Provider Information | |||||||||
| NPI: | 1639570310 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELL | ||||||||
| FirstName: | SUSAN | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 GLEN COVE DR | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | ROCKPORT | ||||||||
| State: | ME | ||||||||
| PostalCode: | 048564235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075935800 | ||||||||
| FaxNumber: | 2075935322 | ||||||||
| Practice Location | |||||||||
| Address1: | 4 GLEN COVE DR | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | ROCKPORT | ||||||||
| State: | ME | ||||||||
| PostalCode: | 048564235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075935800 | ||||||||
| FaxNumber: | 2075935322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2014 | ||||||||
| LastUpdateDate: | 10/08/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | CNP141093 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.