Provider Demographics
NPI:1750548673
Name:WELLS, KAY A (CRNFA)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:A
Last Name:WELLS
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27401 W HIGHWAY 22
Mailing Address - Street 2:SUITE 125
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5934
Mailing Address - Country:US
Mailing Address - Phone:847-381-0388
Mailing Address - Fax:847-381-0811
Practice Address - Street 1:27401 W HIGHWAY 22
Practice Address - Street 2:SUITE 125
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5999
Practice Address - Country:US
Practice Address - Phone:847-381-0388
Practice Address - Fax:847-381-0811
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-239343163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant