Basic Information
| Provider Information | |||||||||
| NPI: | 1770605008 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELL | ||||||||
| FirstName: | SUSANA | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14916 DOBBS AVE | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933145207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6615895113 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6501 TRUXTUN AVE | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933090633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613222206 | ||||||||
| FaxNumber: | 6613277027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 11/30/2012 | ||||||||
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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 | 363L00000X | 9365 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 416452 | 01 | CA | REGISTERED NURSE LICENSE | OTHER | 9365 | 01 | CA | NURSE PRACTIONER | OTHER |