1437390226 NPI number — MS. KRIS ESTELLE BELL RRTE

Table of content: MS. KRIS ESTELLE BELL RRTE (NPI 1437390226)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437390226 NPI number — MS. KRIS ESTELLE BELL RRTE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELL
Provider First Name:
KRIS
Provider Middle Name:
ESTELLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RRTE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437390226
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2310 HOLLY RIDGE CV
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BENTON
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72019-9432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-744-0849
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
190 AVIATION PLZ
Provider Second Line Business Practice Location Address:
SUITES A-D
Provider Business Practice Location Address City Name:
HOT SPRINGS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71913-5529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-525-2770
Provider Business Practice Location Address Fax Number:
501-781-2234
Provider Enumeration Date:
03/09/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 227800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 204896742 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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