Provider Demographics
NPI:1417430588
Name:WELLS, MONICA ANNETTE (FNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:ANNETTE
Last Name:WELLS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:ANNETTE
Other - Last Name:TOSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:323 S MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:CROOKSTON
Mailing Address - State:MN
Mailing Address - Zip Code:56716-1601
Mailing Address - Country:US
Mailing Address - Phone:218-281-9293
Mailing Address - Fax:218-207-0489
Practice Address - Street 1:323 S MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:CROOKSTON
Practice Address - State:MN
Practice Address - Zip Code:56716-1601
Practice Address - Country:US
Practice Address - Phone:218-281-9553
Practice Address - Fax:218-281-9393
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1642988163WX0800X
MN6279363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner