Healthcare Provider Details

I. General information

NPI: 1699233619
Provider Name (Legal Business Name): WHITNEY SIMONE WELLS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL STE R
SANDY SPRINGS GA
30350-2995
US

IV. Provider business mailing address

3695 CUMBERLAND BLVD SE UNIT 1027
ATLANTA GA
30339-3626
US

V. Phone/Fax

Practice location:
  • Phone: 205-413-2377
  • Fax:
Mailing address:
  • Phone: 205-413-2377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-144770
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: