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NPI Code Detail

MEDICARE: TAMARYN CORNELIUS-WELLS NP

MEDICARE: TAMARYN CORNELIUS-WELLS NP
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
1363LA2100XAcute Care Nurse Practitioner17511TN
2363LF0000XFamily Nurse Practitioner17511TN
3363L00000XNurse PractitionerAP131519TX
4363L00000XNurse Practitioner174738MO

General Provider Information

NPI Number : 1306189899
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARYN CORNELIUS-WELLS NP
Provider Business Mailing Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-645-4673
Fax Number :
Provider Business Practice Location Address
First Line : 1265 UNION AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-3415
Country : US
Telephone Number : 901-516-7237
Fax Number : 901-516-7240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2013
Last Update Date : 02/05/2026

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