Basic Information
| Provider Information | |||||||||
| NPI: | 1881769099 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELLFLOWER | ||||||||
| FirstName: | BOBBY | ||||||||
| MiddleName: | BURRELL | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1385 THOUSAND OAKS DR | ||||||||
| Address2: | |||||||||
| City: | HERNANDO | ||||||||
| State: | MS | ||||||||
| PostalCode: | 386327723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6624493803 | ||||||||
| FaxNumber: | 6624493803 | ||||||||
| Practice Location | |||||||||
| Address1: | 853 JEFFERSON AVE | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381032807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9015457366 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LN0000X | R868859 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal |
No ID Information.