Provider Demographics
NPI:1285898965
Name:WELLS, DOLORES ANN (LPN)
Entity type:Individual
Prefix:MRS
First Name:DOLORES
Middle Name:ANN
Last Name:WELLS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHATEAU DR SE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-7201
Mailing Address - Country:US
Mailing Address - Phone:706-235-6581
Mailing Address - Fax:706-291-2753
Practice Address - Street 1:30 CHATEAU DR SE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-7201
Practice Address - Country:US
Practice Address - Phone:706-235-6581
Practice Address - Fax:706-291-2753
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN58135164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse