Healthcare Provider Details

I. General information

NPI: 1962200519
Provider Name (Legal Business Name): TJAUNYAE E WELLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 HILLCREST DRIVE
BELLEVUE NE
68005
US

IV. Provider business mailing address

4670 KANSAS AVE
OMAHA NE
68104
US

V. Phone/Fax

Practice location:
  • Phone: 402-682-6599
  • Fax: 402-682-6563
Mailing address:
  • Phone: 531-777-3091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: