Healthcare Provider Details

I. General information

NPI: 1265252647
Provider Name (Legal Business Name): CHRISTINA MICHELLE WELLS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA MICHELLE RODRIGUEZ

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 MAIN ST STE 140
WINDSOR CO
80550-5559
US

IV. Provider business mailing address

1455 MAIN ST STE 140
WINDSOR CO
80550-5559
US

V. Phone/Fax

Practice location:
  • Phone: 970-686-3950
  • Fax: 970-686-3960
Mailing address:
  • Phone: 970-686-3950
  • Fax: 970-686-3960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1645697
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1000180-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: