Individual
AMANDA B WELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNP
Contact information
Practice address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 259-1405
(320) 259-5896
Mailing address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 240-2826
(320) 259-5896
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R-191079-1
MN
363LA2200X
Adult Health Nurse Practitioner
Primary
R191079-1
MN
Other
Enumeration date
07/24/2012
Last updated
12/18/2014
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