Provider Demographics
NPI:1144478769
Name:BELL, SUSAN ANNE (FNP, BC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANNE
Last Name:BELL
Suffix:
Gender:F
Credentials:FNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N INGALLS ST
Mailing Address - Street 2:SCHOOL OF NURSING, DIVISION II, UNIVERSITY OF MICHIGAN
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-2003
Mailing Address - Country:US
Mailing Address - Phone:734-272-5515
Mailing Address - Fax:
Practice Address - Street 1:312 W HURON ST
Practice Address - Street 2:SHELTER ASSOCIATION OF WASHTENAW COUNTY
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4204
Practice Address - Country:US
Practice Address - Phone:734-662-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704264162363LF0000X
GA135184363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02298988Medicaid