Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 74281 | GA |
N | 207X00000X | Orthopaedic Surgeon | A118962 | CA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | M-13270 | ID |
NPI | 1639495708 |
---|---|
Provider Name | Krysten Marie Bell |
First Address | Boise, ID 83706-5503 |
Second Address | Boise, ID 83706-5503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2010 |
Last Update Date | 10/01/2017 |