Individual
ELISE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2211 W 73RD ST, LOS ANGELES, CA 90043-5308
(323) 559-0447
Mailing address
2211 W 73RD ST, LOS ANGELES, CA 90043-5308
(323) 559-0447
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
706166
CA
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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