Provider Demographics
NPI:1629537188
Name:WELLS, CHEROKEE MOREY (RN)
Entity type:Individual
Prefix:MRS
First Name:CHEROKEE
Middle Name:MOREY
Last Name:WELLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:CHEROKEE
Other - Middle Name:MOREY
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:15909 SAN FELIPE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6505
Mailing Address - Country:US
Mailing Address - Phone:979-721-1014
Mailing Address - Fax:760-873-3935
Practice Address - Street 1:15909 SAN FELIPE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-6505
Practice Address - Country:US
Practice Address - Phone:979-721-1014
Practice Address - Fax:760-873-3935
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX906503163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATHP11576FMedicaid