Provider Demographics
NPI:1700210291
Name:WELLS, NINA M (DNP, PHN, RN)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:M
Last Name:WELLS
Suffix:
Gender:F
Credentials:DNP, PHN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 FALKNER PL
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-1905
Mailing Address - Country:US
Mailing Address - Phone:805-483-0791
Mailing Address - Fax:
Practice Address - Street 1:2001 FALKNER PL
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-1905
Practice Address - Country:US
Practice Address - Phone:805-483-0791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560985163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse