Kathy Bell X

Individual provider Active NPI Contractor · Mansfield, MO

NPI 1962818641 · NPPES record last updated Jul 2, 2014

Key facts

NPI
1962818641
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
46352771400 (MO)
Practice address
113 Summit St
Mansfield, MO 65704-8196
Phone
(417) 664-3695
Fax
(417) 924-8112
NPI assigned
Jul 2, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
46352771400MOMDContractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 46352771400 MO Yes

Addresses

Primary practice location

113 Summit St
Mansfield, MO 65704-8196

Mailing address

113 Summit St
Mansfield, MO 65704-8196
Phone (417) 664-3695

Other identifiers

IdentifierTypeStateIssuer
46352771400MedicaidMO

Other providers in Mansfield, MO

All providers in Mansfield, MO · Contractor in Missouri

Sources for this page

Verify at the official NPI Registry.