Provider Demographics
NPI:1093181885
Name:BELL, AMELIA (PA-C)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1784 UINTA WAY
Mailing Address - Street 2:E2
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-7669
Mailing Address - Country:US
Mailing Address - Phone:435-604-0160
Mailing Address - Fax:435-731-8328
Practice Address - Street 1:1784 UINTA WAY
Practice Address - Street 2:E2
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-7669
Practice Address - Country:US
Practice Address - Phone:435-604-0160
Practice Address - Fax:435-731-8328
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT363AM0700X
UT9527714-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical