Provider Demographics
NPI:1063649655
Name:WELLS, CRAIG STEPHEN (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:STEPHEN
Last Name:WELLS
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Gender:M
Credentials:FNP-BC
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Other - Credentials:
Mailing Address - Street 1:9520 W PALM LN
Mailing Address - Street 2:SUITE #200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-4403
Mailing Address - Country:US
Mailing Address - Phone:623-583-3001
Mailing Address - Fax:623-583-3007
Practice Address - Street 1:7725 N 43RD AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-5770
Practice Address - Country:US
Practice Address - Phone:623-583-3001
Practice Address - Fax:623-583-3007
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2014-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZAP3379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily