Individual
MRS. PRUDENCE MICHELLE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(772) 940-2699
Mailing address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(772) 940-2699
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9215491
FL
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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