Provider Demographics
NPI:1659307890
Name:WELLS, DEBORAH ANN (MSN, APRN-BC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANN
Last Name:WELLS
Suffix:
Gender:F
Credentials:MSN, APRN-BC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:SLATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 24387
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37422
Mailing Address - Country:US
Mailing Address - Phone:423-648-8480
Mailing Address - Fax:423-648-8481
Practice Address - Street 1:2000 STEIN DRIVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421
Practice Address - Country:US
Practice Address - Phone:423-648-8480
Practice Address - Fax:423-648-8481
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011670363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3643053Medicare ID - Type Unspecified
Q68205Medicare UPIN