Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 200500188 | NC |
NPI | 1093921744 |
---|---|
Provider Name | Jessica Bell |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204-2450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 30/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5910998 | (05) | NC |
NC1282 | (05) | SC |