Healthcare Provider Details

I. General information

NPI: 1649070814
Provider Name (Legal Business Name): HANNAH M WELLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1972 CLARK AVE
ALLIANCE OH
44601-3993
US

IV. Provider business mailing address

5293 GOLFWAY LN
LYNDHURST OH
44124-3735
US

V. Phone/Fax

Practice location:
  • Phone: 800-992-6682
  • Fax:
Mailing address:
  • Phone: 216-559-3420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: