MEDICARE: AARON WELLS RN

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
1	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	201242138RN	OR
2	163WS0200X	School Registered Nurse	285526	AZ

General Provider Information

NPI Number	:	1194116822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON WELLS RN

Provider Business Mailing Address
First Line	:	3285 E SPARROW AVE
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86004-7794
Country	:	US
Telephone Number	:	928-527-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 SILVER SADDLE RD
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86004-3207
Country	:	US
Telephone Number	:	928-773-4150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2015
Last Update Date	:	01/19/2023

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