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NPI Code Detail

MEDICARE: AMY ELIZABETH WELLS APRN

MEDICARE: AMY ELIZABETH WELLS APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2363LF0000XFamily Nurse Practitioner1139480TX

General Provider Information

NPI Number : 1063295426
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY ELIZABETH WELLS APRN
Provider Business Mailing Address
First Line : 220 LIVINGSTON DR
Second Line :
City : HICKORY CREEK
State : TX
Zip : 75065-2959
Country : US
Telephone Number : 214-797-6503
Fax Number :
Provider Business Practice Location Address
First Line : 2280 HIGHLAND VILLAGE RD STE 130
Second Line :
City : HIGHLAND VILLAGE
State : TX
Zip : 75077-7189
Country : US
Telephone Number : 972-317-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2023
Last Update Date : 10/20/2023

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