Provider Demographics
NPI:1720544091
Name:THOMPSON BELL, GRACE ELIZABETH (AGACNP-BC, AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ELIZABETH
Last Name:THOMPSON BELL
Suffix:
Gender:
Credentials:AGACNP-BC, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 DEER TRAIL CIR
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-1315
Mailing Address - Country:US
Mailing Address - Phone:805-709-0697
Mailing Address - Fax:
Practice Address - Street 1:715 TANK FARM RD STE C
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7068
Practice Address - Country:US
Practice Address - Phone:805-543-5577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN272588363LA2100X, 363LA2200X
CA95031483363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care