Individual
ANTOINISHA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 316-5151
Mailing address
6121 WAYNE AVE APT 1, PHILADELPHIA, PA 19144-6121
(267) 701-9034
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
SP030696
PA
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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