Healthcare Provider Details

I. General information

NPI: 1083741003
Provider Name (Legal Business Name): REBEKAH V WELLS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S HAVANA ST
AURORA CO
80014-1618
US

IV. Provider business mailing address

5947 S YAKIMA ST
AURORA CO
80015-6655
US

V. Phone/Fax

Practice location:
  • Phone: 303-699-3642
  • Fax:
Mailing address:
  • Phone: 303-858-0725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number122856
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: