Provider Demographics
NPI:1790204766
Name:WELLS, CARLY JANE (DNP, NP-C)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:JANE
Last Name:WELLS
Suffix:
Gender:F
Credentials:DNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4123
Mailing Address - Fax:970-624-2416
Practice Address - Street 1:16951 E QUINCY AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1901
Practice Address - Country:US
Practice Address - Phone:303-752-5480
Practice Address - Fax:303-752-5481
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0993380363LF0000X
COAPN.0993380-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily