Individual
MRS. VICKY MARIE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MIDWIFE
Contact information
Practice address
421 S BONNER AVE, TYLER, TX 75702-8034
(903) 526-2600
(903) 526-2605
Mailing address
421 S BONNER AVE, TYLER, TX 75702-8034
(903) 526-2600
(903) 526-2605
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
99030
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3361719
—
TX
Enumeration date
11/27/2007
Last updated
06/14/2016
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