Individual
MRS. MARYANN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
12471 BIRCH ST, YUCAIPA, CA 92399-4217
(909) 797-0230
Mailing address
12471 BIRCH ST, YUCAIPA, CA 92399-4217
(909) 797-0230
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
697325
CA
Other
Enumeration date
02/15/2011
Last updated
02/15/2011
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