Provider Demographics
NPI:1326818469
Name:WELLS, MELINDA ANN (CNA)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANN
Last Name:WELLS
Suffix:
Gender:F
Credentials:CNA
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 8403
Mailing Address - Street 2:
Mailing Address - City:MADERIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33738
Mailing Address - Country:US
Mailing Address - Phone:813-644-9081
Mailing Address - Fax:
Practice Address - Street 1:17105 GULF BLVD
Practice Address - Street 2:APT 126
Practice Address - City:NORTH REDINGTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33708-3370
Practice Address - Country:US
Practice Address - Phone:727-418-5484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2091135253Z00000X, 372600000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion