Provider Demographics
NPI:1306541834
Name:WELLS, KAREN ANGELA
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANGELA
Last Name:WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 CULLEN AVE
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-3304
Mailing Address - Country:US
Mailing Address - Phone:419-562-7031
Mailing Address - Fax:
Practice Address - Street 1:1315 CULLEN AVE
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-3304
Practice Address - Country:US
Practice Address - Phone:419-562-7031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide