Healthcare Provider Details

I. General information

NPI: 1942477575
Provider Name (Legal Business Name): WENDY ROSENCRANS WELLS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDY L ROSENCRANS WELLS NP

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 MARSHALL WAY # 100
PLACERVILLE CA
95667-5722
US

IV. Provider business mailing address

PO BOX 45680
PLACERVILLE CA
95667-5746
US

V. Phone/Fax

Practice location:
  • Phone: 530-626-2920
  • Fax: 530-626-2948
Mailing address:
  • Phone: 530-626-2618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number699762
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: