Provider Demographics
NPI:1114216546
Name:WELLS, JUDY R (CERTIFIED NURSE AIDE)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:R
Last Name:WELLS
Suffix:
Gender:F
Credentials:CERTIFIED NURSE AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 WILCREST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-1078
Mailing Address - Country:US
Mailing Address - Phone:713-550-6069
Mailing Address - Fax:
Practice Address - Street 1:606 WILCREST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-1078
Practice Address - Country:US
Practice Address - Phone:713-550-6069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty