Provider Demographics
NPI:1487641494
Name:WELLS, SYLVIA KENT (RN MSN FNP)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:KENT
Last Name:WELLS
Suffix:
Gender:F
Credentials:RN MSN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4812 N BARTLETT AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3849
Mailing Address - Country:US
Mailing Address - Phone:956-726-9797
Mailing Address - Fax:956-726-9965
Practice Address - Street 1:4812 N BARTLETT AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3849
Practice Address - Country:US
Practice Address - Phone:956-726-9797
Practice Address - Fax:956-726-9965
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX645091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ50433Medicare UPIN
TX611922Medicare ID - Type Unspecified