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NPI Code Detail

MEDICARE: MR. DAVID WAYNE WELLER FNP

MEDICARE:  MR. DAVID WAYNE WELLER  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner13720CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10376959-22OTHERANCC

General Provider Information

NPI Number : 1033388723
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID WAYNE WELLER FNP
Provider Business Mailing Address
First Line : 1673 COLUMBUS RD
Second Line :
City : WEST SACRAMENTO
State : CA
Zip : 95691-4902
Country : US
Telephone Number : 916-813-9333
Fax Number : 916-374-0340
Provider Business Practice Location Address
First Line : 1673 COLUMBUS RD
Second Line :
City : WEST SACRAMENTO
State : CA
Zip : 95691-4902
Country : US
Telephone Number : 916-813-9333
Fax Number : 916-374-0340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2008
Last Update Date : 02/27/2008

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Directions to “ MR. DAVID WAYNE WELLER FNP” Practice Location

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