Basic Information
| Provider Information | |||||||||
| NPI: | 1326063595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELL | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | THIELMAN | ||||||||
| OtherFirstName: | JULIE | ||||||||
| OtherMiddleName: | MARIE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 811 2ND ST SE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | LITTLE FALLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563453505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3206317000 | ||||||||
| FaxNumber: | 3206320534 | ||||||||
| Practice Location | |||||||||
| Address1: | 811 2ND ST SE STE A | ||||||||
| Address2: | |||||||||
| City: | LITTLE FALLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563453505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3206317000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 12/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 36468 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | A002 | 01 | MN | TRICARE | OTHER | 0101380 | 01 | MEDICA | OTHER | 21620 | 01 | AMERICA'S PPO | OTHER | HP25404 | 01 | HEALTH PARTNERS | OTHER | NA9231008732 | 01 | PREFERRED ONE | OTHER | 080075942 | 01 | MN | RR MEDICARE | OTHER | 120264C736 | 01 | MN | UCARE MINNESOTA | OTHER | 160222500 | 05 | MN | MEDICAID | 7D611BE | 01 | MN | BCBS OF MINNESOTA | OTHER |