Provider Demographics
NPI:1336945435
Name:WELLS, QUENTINA
Entity type:Individual
Prefix:
First Name:QUENTINA
Middle Name:
Last Name:WELLS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3392 TIVOLI CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-5015
Mailing Address - Country:US
Mailing Address - Phone:614-592-9267
Mailing Address - Fax:
Practice Address - Street 1:3392 TIVOLI CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-5015
Practice Address - Country:US
Practice Address - Phone:614-592-9267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant