Individual
MERRY WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2475 5TH ST N, COLUMBUS, MS 39705-2005
(662) 328-1254
Mailing address
2475 5TH ST N, COLUMBUS, MS 39705-2005
(662) 328-1254
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
901416
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08156515
—
MS
Enumeration date
01/21/2016
Last updated
01/04/2019
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