Individual
ERIC N WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
215 E HAWAII AVENUE, NAMPA, ID 83686
(208) 463-3234
(208) 463-3044
Mailing address
217 W GEORGIA AVE, SUITE 115, NAMPA, ID 83686-6811
(208) 463-3234
(208) 463-3044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-642
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807594700
—
ID
Enumeration date
11/30/2006
Last updated
12/14/2009
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