Provider Demographics
NPI:1972149698
Name:WELLS, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9970 CENTRAL PARK BLVD N STE 400B
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-2231
Mailing Address - Country:US
Mailing Address - Phone:561-487-7931
Mailing Address - Fax:561-487-1204
Practice Address - Street 1:9970 CENTRAL PARK BLVD N STE 400-B
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-2231
Practice Address - Country:US
Practice Address - Phone:561-487-7931
Practice Address - Fax:561-487-1204
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL432491163W00000X
FL9527190163W00000X
FLAPRN11008817363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse