Provider Demographics
NPI:1770721003
Name:WELLS, CHERYL JEAN (FNP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:JEAN
Last Name:WELLS
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:PO BOX 1850
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:27298-1850
Mailing Address - Country:US
Mailing Address - Phone:336-622-3000
Mailing Address - Fax:336-622-3010
Practice Address - Street 1:129 S FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:27298-3200
Practice Address - Country:US
Practice Address - Phone:336-301-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC145470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily