Provider Demographics
NPI:1215276977
Name:WELLS, ANNA M (APRN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:WELLS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 N JESSE JAMES RD SUITE #1
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024
Mailing Address - Country:US
Mailing Address - Phone:816-630-9411
Mailing Address - Fax:816-630-9417
Practice Address - Street 1:1006 N JESSE JAMES RD SUITE #1
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024
Practice Address - Country:US
Practice Address - Phone:816-630-9411
Practice Address - Fax:816-630-9417
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013001555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily