MEDICARE: MRS. ANGELA SUE WELLES AGNP-C

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	363LP2300X	Primary Care Nurse Practitioner	NUR-APRN-LIC-290191	MT

General Provider Information

NPI Number	:	1740114065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA SUE WELLES AGNP-C

Provider Business Mailing Address
First Line	:	70 LIME KILN RD
Second Line	:
City	:	BUTTE
State	:	MT
Zip	:	59701-9778
Country	:	US
Telephone Number	:	406-490-0143
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 THREE BEARS DR
Second Line	:
City	:	BUTTE
State	:	MT
Zip	:	59701-7171
Country	:	US
Telephone Number	:	406-496-3000
Fax Number	:

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

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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