Individual
JACQUELYN K WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8038 N 600 W STE 100, MCCORDSVILLE, IN 46055-8605
(179) 323-4263
(855) 563-1016
Mailing address
8038 N 600 W STE 100, MCCORDSVILLE, IN 46055-8605
(317) 932-3426
(855) 631-0165
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008805A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102592021
ANTHEM PTAN
IN
05
—
300027246
—
IN
Enumeration date
01/21/2019
Last updated
08/04/2025
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