Healthcare Provider Details

I. General information

NPI: 1598685067
Provider Name (Legal Business Name): MEGAN WELLS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17978 SR 55
BAKER WV
26801
US

IV. Provider business mailing address

504 FRONTIER LN
NEW CREEK WV
26743-9049
US

V. Phone/Fax

Practice location:
  • Phone: 304-897-5915
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number113286
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: