Provider Demographics
NPI:1003042938
Name:WELLS, ADRIENNE MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MARIE
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 1:4879 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2332
Mailing Address - Country:US
Mailing Address - Phone:440-683-4670
Mailing Address - Fax:440-683-4670
Practice Address - Street 1:4879 OAKLAND DR
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2332
Practice Address - Country:US
Practice Address - Phone:440-683-4670
Practice Address - Fax:440-683-4670
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN097621164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse