Individual
JAMES MICKEY WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
80 NEWNAN STATION DRIVE, SUITE A, NEWNAN, GA 30265
(770) 251-2060
(678) 854-9235
Mailing address
PO BOX 73709, NEWNAN, GA 30271-3709
(770) 251-2060
(678) 854-9235
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN077790
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN077790
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000535565G
—
GA
Enumeration date
06/27/2005
Last updated
04/16/2015
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