MEDICARE: MONIQUE S 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
1	372500000X	Chore Provider

General Provider Information

NPI Number	:	1740179985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE S WELLS

Provider Business Mailing Address
First Line	:	5736 N 33RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68111-1616
Country	:	US
Telephone Number	:	402-813-7936
Fax Number	:	402-813-7936

Provider Business Practice Location Address
First Line	:	3708 FRANCES ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-3178
Country	:	US
Telephone Number	:	402-813-7936
Fax Number	:

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

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/08/2025

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Directions to “ MONIQUE S WELLS ” Practice Location

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