Healthcare Provider Details

I. General information

NPI: 1518896208
Provider Name (Legal Business Name): WILLIAM WELLS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19287 WINMEADE DR
LANSDOWNE VA
20176-6513
US

IV. Provider business mailing address

19287 WINMEADE DR
LANSDOWNE VA
20176-6513
US

V. Phone/Fax

Practice location:
  • Phone: 571-225-9765
  • Fax:
Mailing address:
  • Phone: 571-225-9765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number0001178337
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number0001178337
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number0001178337
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number0001178337
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: