Provider Demographics
NPI:1629774211
Name:WELLSPRING GROUP
Entity Type:Organization
Organization Name:WELLSPRING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, CNM
Authorized Official - Phone:970-402-3883
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:CANYONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97417-0157
Mailing Address - Country:US
Mailing Address - Phone:970-402-3882
Mailing Address - Fax:
Practice Address - Street 1:790 HIGH ST
Practice Address - Street 2:
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-7662
Practice Address - Country:US
Practice Address - Phone:970-402-3882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty