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NPI Code Detail

MEDICARE: VANESSA WELLS

MEDICARE: VANESSA WELLS
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
1183500000XPharmacist2021024788MO

General Provider Information

NPI Number : 1215500525
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA WELLS
Provider Business Mailing Address
First Line : 100 N GRAND AVE
Second Line :
City : HOUSTON
State : MO
Zip : 65483-1222
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 N GRAND AVE
Second Line :
City : HOUSTON
State : MO
Zip : 65483-1222
Country : US
Telephone Number : 417-967-3315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2021
Last Update Date : 07/23/2021

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Directions to “ VANESSA WELLS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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