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NPI 1942074075

NPI 1942074075 : HANNAH MARIE WELLS PA : SWEETWATER, TN

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General NPI Number Information
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    NPI Number           |    1942074075
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    Entity Type          |    Individual 
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    Provider Name        |    HANNAH MARIE WELLS PA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/09/2023
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    Last Update Date     |    01/16/2025
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Provider Practice Location Address
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    Address Line         |    791 NEW HIGHWAY 68 STE 1 
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    City                 |    SWEETWATER
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    State                |    TN
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    Zip                  |    37874-1906
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    Country              |    US
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    Telephone            |    423-836-9304
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    791 NEW HIGHWAY 68 STE 1 
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    City                 |    SWEETWATER
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    State                |    TN
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    Zip                  |    37874-1906
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    Country              |    US
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    Telephone            |    423-836-9304
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    50.009190RX
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    License Number State |    OH
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA0000005790
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    License Number State |    TN
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