Provider Demographics
NPI:1982690657
Name:WELLS-GOOD, DEBBIE (FNP)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:WELLS-GOOD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-4877
Mailing Address - Country:US
Mailing Address - Phone:423-929-2584
Mailing Address - Fax:423-542-5109
Practice Address - Street 1:401 E MAIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4877
Practice Address - Country:US
Practice Address - Phone:423-929-2584
Practice Address - Fax:423-542-5109
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN49189363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner