Provider Demographics
NPI:1194765875
Name:BELL, NANCY KAREN (PA-C)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:KAREN
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 1:286 WEBB RD
Mailing Address - Street 2:
Mailing Address - City:PINEY FLATS
Mailing Address - State:TN
Mailing Address - Zip Code:37686-4324
Mailing Address - Country:US
Mailing Address - Phone:423-292-1718
Mailing Address - Fax:
Practice Address - Street 1:JAMES H. QUILLEN VAMC
Practice Address - Street 2:DOGWOOD AVE. 111C
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-979-3497
Practice Address - Fax:423-979-3423
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000000512363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3668371Medicare ID - Type Unspecified
TNS76355Medicare UPIN