Individual
MRS. JACQUELINE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
502 STEVENS AVE UNIT 1B, PORTLAND, ME 04103-2611
(207) 894-4806
Mailing address
16 BENJAMIN WAY, GORHAM, ME 04038-2783
(518) 209-1874
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN74872
ME
Other
Enumeration date
01/08/2026
Last updated
01/08/2026
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