Provider Demographics
NPI:1407104185
Name:WELLS, LASHONTA TAMIKA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LASHONTA
Middle Name:TAMIKA
Last Name:WELLS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:615-425-4268
Practice Address - Street 1:7615 US HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-2054
Practice Address - Country:US
Practice Address - Phone:901-969-1773
Practice Address - Fax:901-969-1774
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN16794363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily