Provider Demographics
NPI:1538053301
Name:WELLS, JAYDEN NICHOLE (LPN)
Entity type:Individual
Prefix:
First Name:JAYDEN
Middle Name:NICHOLE
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 1:519 S JARDOT RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-3945
Mailing Address - Country:US
Mailing Address - Phone:405-328-0532
Mailing Address - Fax:
Practice Address - Street 1:519 S JARDOT RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-3945
Practice Address - Country:US
Practice Address - Phone:405-328-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK222839164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse