Provider Demographics
NPI:1265552004
Name:WELLS, MARGARET (CNP)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 CONNER AVE.
Mailing Address - Street 2:SUITE 2691
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213
Mailing Address - Country:US
Mailing Address - Phone:313-692-8400
Mailing Address - Fax:
Practice Address - Street 1:5555 CONNER AVE.
Practice Address - Street 2:SUITE 2691
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213
Practice Address - Country:US
Practice Address - Phone:313-692-8400
Practice Address - Fax:313-692-8431
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704195317363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner