Provider Demographics
NPI:1932357290
Name:WELLS, KAREN JANELL (AUD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JANELL
Last Name:WELLS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9045 CHARLESTON WAY
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8344
Mailing Address - Country:US
Mailing Address - Phone:502-633-4009
Mailing Address - Fax:502-633-4009
Practice Address - Street 1:9045 CHARLESTON WAY
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-8344
Practice Address - Country:US
Practice Address - Phone:502-633-4009
Practice Address - Fax:502-633-4009
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0364231H00000X
246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY765003Medicare PIN
KY765202Medicare PIN
KYP88412Medicare UPIN