Provider Demographics
NPI:1992175046
Name:BELL, NAYANNA HAGE (PA-C)
Entity type:Individual
Prefix:MS
First Name:NAYANNA
Middle Name:HAGE
Last Name:BELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NAYANNA
Other - Middle Name:
Other - Last Name:HAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13943 N. 91ST AVE, B101
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381
Mailing Address - Country:US
Mailing Address - Phone:949-650-3350
Mailing Address - Fax:949-650-1274
Practice Address - Street 1:13943 N. 91ST AVE, B101
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381
Practice Address - Country:US
Practice Address - Phone:623-476-5190
Practice Address - Fax:949-650-1274
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA52642363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical