Provider Demographics
NPI:1881032662
Name:WELLS, LAURA ANN (APRN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:WELLS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-4775
Practice Address - Street 1:2301 LEXINGTON AVE STE 135
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2800
Practice Address - Country:US
Practice Address - Phone:606-408-8400
Practice Address - Fax:606-408-6770
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0086759Medicaid
KYP01227322OtherRAILROAD MEDICARE
KY7100259220Medicaid
KY7100259220Medicaid