Provider Demographics
NPI:1689162349
Name:WELLS, KATHRYN-CARRIE SUE (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN-CARRIE
Middle Name:SUE
Last Name:WELLS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 WALLER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2930
Mailing Address - Country:US
Mailing Address - Phone:859-254-7000
Mailing Address - Fax:859-255-4381
Practice Address - Street 1:330 WALLER AVE STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504
Practice Address - Country:US
Practice Address - Phone:859-254-7000
Practice Address - Fax:859-255-4381
Is Sole Proprietor?:No
Enumeration Date:2018-04-28
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily