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General NPI Number Information
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NPI Number | 1669393849
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Entity Type | Individual
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Provider Name | SAMANTHA RILEY WELLS FNP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 1550 EATONTON RD
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City | MADISON
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State | GA
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Zip | 30650-4627
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Country | US
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Telephone | 706-438-6486
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Fax |
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Provider Business Mailing Address
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Address Line | 492 POPLAR ST
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City | MADISON
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State | GA
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Zip | 30650-1622
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Country | US
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Telephone | 706-438-6486
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP308787
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License Number State | GA
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