Provider Demographics
NPI:1295827970
Name:WELLS, KENDRA (CRNA)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE CHILDREN'S PLAZA - DAYTON CHILDREN'S HOSPITAL
Mailing Address - Street 2:CHILDREN'S ANESTHESIA GROUP, INC.
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1815
Mailing Address - Country:US
Mailing Address - Phone:937-641-3350
Mailing Address - Fax:937-641-6145
Practice Address - Street 1:ONE CHILDEN'S PLAZA - DAYTON CHILDREN'S HOSPITAL
Practice Address - Street 2:CHILDREN'S CARE GROUP, INC.
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1815
Practice Address - Country:US
Practice Address - Phone:937-641-3350
Practice Address - Fax:937-641-5145
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08889-NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered