MEDICARE: DR. DEEDRA RAE WELLS N.D.

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	175F00000X	Naturopath	70055490	WA

General Provider Information

NPI Number	:	1780617662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEEDRA RAE WELLS N.D.

Provider Business Mailing Address
First Line	:	520 ASHLAND DR
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27403-1909
Country	:	US
Telephone Number	:	503-319-2496
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 ASHLAND DR
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27403-1909
Country	:	US
Telephone Number	:	503-319-2496
Fax Number	:

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	12/18/2025

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