Provider Demographics
NPI:1528293339
Name:WELLS, JANELLE MARIE (MD)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:MARIE
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:MARIE
Other - Last Name:DURST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-3190
Mailing Address - Country:US
Mailing Address - Phone:757-736-3725
Mailing Address - Fax:757-431-7782
Practice Address - Street 1:100 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-3190
Practice Address - Country:US
Practice Address - Phone:757-736-3725
Practice Address - Fax:757-431-7782
Is Sole Proprietor?:No
Enumeration Date:2009-05-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101260648207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology