Provider Demographics
NPI:1225317795
Name:WELLS, ANN MARIE (FNP-BC, APNP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:WELLS
Suffix:
Gender:F
Credentials:FNP-BC, APNP
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 365
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:WI
Mailing Address - Zip Code:54155
Mailing Address - Country:US
Mailing Address - Phone:920-869-2711
Mailing Address - Fax:920-869-1077
Practice Address - Street 1:525 AIRPORT DR.
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:WI
Practice Address - Zip Code:54155
Practice Address - Country:US
Practice Address - Phone:920-869-2711
Practice Address - Fax:920-869-1077
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4505-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily