Provider Demographics
NPI:1609185511
Name:WELLS, KARLA
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:OH
Mailing Address - Zip Code:45836-1036
Mailing Address - Country:US
Mailing Address - Phone:567-295-0066
Mailing Address - Fax:
Practice Address - Street 1:301 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:OH
Practice Address - Zip Code:45836-1036
Practice Address - Country:US
Practice Address - Phone:567-295-0066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN085046IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse