Healthcare Provider Details

I. General information

NPI: 1760946925
Provider Name (Legal Business Name): ALLISON M. WELLE DNP, APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 4TH ST SE
ROCHESTER MN
55904-4717
US

IV. Provider business mailing address

851 DIAMOND RIDGE LN NW
ROCHESTER MN
55901-6502
US

V. Phone/Fax

Practice location:
  • Phone: 507-529-6605
  • Fax:
Mailing address:
  • Phone: 507-450-3693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number2265474
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number403
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: