Provider Demographics
NPI:1841592276
Name:WELLS-MCGHEE, QUALA A (FNP)
Entity Type:Individual
Prefix:MS
First Name:QUALA
Middle Name:A
Last Name:WELLS-MCGHEE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:QUALA
Other - Middle Name:A
Other - Last Name:MCGHEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34985 ALLIUM LN
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8961
Mailing Address - Country:US
Mailing Address - Phone:951-599-4861
Mailing Address - Fax:
Practice Address - Street 1:200 MERCY CIRCLE
Practice Address - Street 2:
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:773-425-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1710I1002X
CA95015032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman