Provider Demographics
NPI:1699233619
Name:WELLS, WHITNEY SIMONE (RN)
Entity type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:SIMONE
Last Name:WELLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19934
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35219-0934
Mailing Address - Country:US
Mailing Address - Phone:205-413-2377
Mailing Address - Fax:
Practice Address - Street 1:813 GREEN SPRINGS HWY
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35219-2002
Practice Address - Country:US
Practice Address - Phone:205-413-2377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-144770163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty