Healthcare Provider Details

I. General information

NPI: 1073061552
Provider Name (Legal Business Name): DAVID T WELLS FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E PROSPECT RD
FORT COLLINS CO
80525-9718
US

IV. Provider business mailing address

2500 E PROSPECT RD
FORT COLLINS CO
80525-9718
US

V. Phone/Fax

Practice location:
  • Phone: 970-493-0112
  • Fax: 970-493-1794
Mailing address:
  • Phone: 970-493-0112
  • Fax: 970-493-1794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0999685-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP 4771
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: