Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2102 | ME |
N | 2081P2900X | Pain Medicine | 229603 | MA |
NPI | 1386810968 |
---|---|
Provider Name | Ms. Jessica Bell |
First Address | Topsham, ME 04086-1265 |
Second Address | Topsham, ME 04086-1265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2008 |
Last Update Date | 16/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
434177099 | (05) | ME |