Individual
ANIEDRA GERALDINE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPRSS, CHW-I
Contact information
Practice address
1229 PAVILIONS AVE, NORTH LAS VEGAS, NV 89031-2321
(702) 670-8900
Mailing address
5546 CAMINO AL NORTE # 2-261, NORTH LAS VEGAS, NV 89031-0805
(702) 483-1230
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
CHW1-6112
NV
175T00000X
Peer Specialist
Primary
PRSS-5315
NV
Other
Enumeration date
05/06/2025
Last updated
05/06/2025
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