Provider Demographics
NPI:1336885029
Name:BELL, LISA (DNP, WHNP-BC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:DNP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S 1100 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2509
Mailing Address - Country:US
Mailing Address - Phone:530-921-8170
Mailing Address - Fax:
Practice Address - Street 1:434 E 5350 S STE D
Practice Address - Street 2:
Practice Address - City:WASHINGTON TERRACE
Practice Address - State:UT
Practice Address - Zip Code:84405-5417
Practice Address - Country:US
Practice Address - Phone:801-479-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12304845-3102163W00000X
UT12304845-4405363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse