Healthcare Provider Details

I. General information

NPI: 1972570786
Provider Name (Legal Business Name): JAMA R WELLS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMA W ARNETT PA-C

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 WASHINGTON AVE # 2200
EVANSVILLE IN
47714-0541
US

IV. Provider business mailing address

3700 WASHINGTON AVE # 2200
EVANSVILLE IN
47714-0541
US

V. Phone/Fax

Practice location:
  • Phone: 812-485-7111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10000631A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA741
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: