Individual
LOU ANN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 968-1228
Mailing address
106 RIMROCK DR, CLINTON, MS 39056-5012
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R877839
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
905761
MS
Other
Enumeration date
11/04/2019
Last updated
12/03/2024
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