Healthcare Provider Details

I. General information

NPI: 1760658355
Provider Name (Legal Business Name): KARA OBRIEN WELLS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 NICHOLASVILLE RD SUITE 701
LEXINGTON KY
40503-1431
US

IV. Provider business mailing address

1700 NICHOLASVILLE RD SUITE 701
LEXINGTON KY
40503-1431
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-0396
  • Fax:
Mailing address:
  • Phone: 859-278-0396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number42738
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: