Individual
MICHELLE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
810 S 6TH ST, MONTICELLO, IN 47960-8201
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28177383A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006332A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001025850
ANTHEM PROVIDER NUMBER
IN
05
—
201368460
—
IN
Enumeration date
11/30/2015
Last updated
09/30/2022
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