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NPI Code Detail

MEDICARE: SANDRA WELLS FNP-BC

MEDICARE: SANDRA WELLS FNP-BC
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
1363L00000XNurse Practitioner21948TN
2363LF0000XFamily Nurse PractitionerAPN21948TN

General Provider Information

NPI Number : 1801347679
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA WELLS FNP-BC
Provider Business Mailing Address
First Line : 1275 DICK LONAS RD UNIT 101
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-1383
Country : US
Telephone Number : 865-584-4747
Fax Number : 933-908-0998
Provider Business Practice Location Address
First Line : 555 JUSTIS DR
Second Line :
City : GREENEVILLE
State : TN
Zip : 37745-4288
Country : US
Telephone Number : 423-783-7965
Fax Number : 833-908-2073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2016
Last Update Date : 03/08/2022

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Directions to “ SANDRA WELLS FNP-BC” Practice Location

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