Provider Demographics
NPI:1356864045
Name:WELLS, ANGELA JANE (CNM)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:JANE
Last Name:WELLS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1560 TURF LN
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6392
Mailing Address - Country:US
Mailing Address - Phone:517-853-2343
Mailing Address - Fax:517-484-6358
Practice Address - Street 1:5449 S OCCIDENTAL RD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-9782
Practice Address - Country:US
Practice Address - Phone:517-264-0590
Practice Address - Fax:517-366-5021
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2023-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.019339367A00000X
MI4704304219367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife