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General NPI Number Information
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NPI Number | 1326458159
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Entity Type | Individual
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Provider Name | HEATHER ELAINE WELLS D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/01/2014
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 807 HIGHWAY 22
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City | WEWAHITCHKA
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State | FL
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Zip | 32465-3237
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Country | US
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Telephone | 850-568-1053
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Fax |
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Provider Business Mailing Address
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Address Line | 849 W GULF BEACH DR
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City | SAINT GEORGE ISLAND
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State | FL
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Zip | 32328-2512
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Country | US
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Telephone | 850-419-7319
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS14757
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DOS-2231
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License Number State | HI
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