Provider Demographics
NPI:1588353791
Name:BELL, THURSDAY TAMARA (LPN)
Entity type:Individual
Prefix:MRS
First Name:THURSDAY
Middle Name:TAMARA
Last Name:BELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:684 RILEY ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14211-1222
Mailing Address - Country:US
Mailing Address - Phone:716-239-5974
Mailing Address - Fax:
Practice Address - Street 1:684 RILEY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14211-1222
Practice Address - Country:US
Practice Address - Phone:716-239-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330960164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty