Healthcare Provider Details

I. General information

NPI: 1427967439
Provider Name (Legal Business Name): BRYANA DAWN WELLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 CHERRY ST
MIDDLEBOURNE WV
26149-9618
US

IV. Provider business mailing address

PO BOX 68
MIDDLEBOURNE WV
26149-0068
US

V. Phone/Fax

Practice location:
  • Phone: 304-758-4919
  • Fax: 304-758-4680
Mailing address:
  • Phone: 304-758-4919
  • Fax: 304-758-4680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: