Provider Demographics
NPI:1801641766
Name:WELLS, BRIANNA KATHERINE
Entity type:Individual
Prefix:MS
First Name:BRIANNA
Middle Name:KATHERINE
Last Name:WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 INTERSTATE PKWY
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-2924
Mailing Address - Country:US
Mailing Address - Phone:814-366-1202
Mailing Address - Fax:
Practice Address - Street 1:583 N QUEEN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603
Practice Address - Country:US
Practice Address - Phone:717-393-1900
Practice Address - Fax:717-553-5040
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical