Provider Demographics
NPI:1972853729
Name:WELLINS, ANNA-MARIE (ANP)
Entity Type:Individual
Prefix:
First Name:ANNA-MARIE
Middle Name:
Last Name:WELLINS
Suffix:
Gender:F
Credentials:ANP
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 2340
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11969-2340
Mailing Address - Country:US
Mailing Address - Phone:631-283-2430
Mailing Address - Fax:631-283-7496
Practice Address - Street 1:3330 NOYAC RD
Practice Address - Street 2:BURKESHIRE COURT BUILDING A
Practice Address - City:SAG HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11963-1930
Practice Address - Country:US
Practice Address - Phone:631-725-2112
Practice Address - Fax:631-725-7180
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306116363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health