Provider Demographics
NPI:1386282903
Name:BELL, KRISTY LYNN
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:LYNN
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 TODD STREET FLATWOODS
Mailing Address - Street 2:
Mailing Address - City:FLATWOODS
Mailing Address - State:KY
Mailing Address - Zip Code:41139
Mailing Address - Country:US
Mailing Address - Phone:606-547-5936
Mailing Address - Fax:
Practice Address - Street 1:2414 TODD STREET FLATWOODS
Practice Address - Street 2:
Practice Address - City:FLATWOODS
Practice Address - State:KY
Practice Address - Zip Code:41139
Practice Address - Country:US
Practice Address - Phone:606-547-5936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214854224Z00000X
KY173310224Z00000X
AL5041224Z00000X
OHOTA003085224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant