Individual
MARIA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6051 U S HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-7000
Mailing address
575 LILLIS RD, COLUMBIA, MS 39429-8927
(601) 441-1844
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904780
MS
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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