Provider Demographics
NPI:1811235831
Name:WELLS, ELIZABETH ABBIGAIL (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ABBIGAIL
Last Name:WELLS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6314 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-7320
Mailing Address - Country:US
Mailing Address - Phone:850-479-2544
Mailing Address - Fax:850-479-7240
Practice Address - Street 1:6314 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-7320
Practice Address - Country:US
Practice Address - Phone:850-479-2544
Practice Address - Fax:850-479-7240
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist