Provider Demographics
NPI:1598774374
Name:WELLS, MARY JEAN (MSN, ANP-C)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:JEAN
Last Name:WELLS
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Gender:F
Credentials:MSN, ANP-C
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Mailing Address - Street 1:549 E. BRAMBLETON AVE.
Mailing Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL NORFOLK, LLC
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510
Mailing Address - Country:US
Mailing Address - Phone:757-533-9441
Mailing Address - Fax:757-282-7600
Practice Address - Street 1:549 E. BRAMBLETON AVE.
Practice Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL NORFOLK, LLC
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510
Practice Address - Country:US
Practice Address - Phone:757-533-9441
Practice Address - Fax:757-282-7600
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2014-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF301590363LA2200X
VA0024169788363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health