Provider Demographics
NPI:1770556946
Name:BELL, JANE ELIZABETH (APRN NPC)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:ELIZABETH
Last Name:BELL
Suffix:
Gender:F
Credentials:APRN NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3607 GOLDEN HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6169
Mailing Address - Country:US
Mailing Address - Phone:801-694-6959
Mailing Address - Fax:
Practice Address - Street 1:GEORGE E WHALEN VA MED CENTER (111P)
Practice Address - Street 2:500 FOOTHILL BLVD
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148-0001
Practice Address - Country:US
Practice Address - Phone:801-582-1565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT215186-8900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT215186-8900OtherAPRN LICENSE
DAV000Medicare UPIN