Individual
CAROLINE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
721 RIVER DR, SUITE A, FORT BRAGG, CA 95437
(707) 961-4631
Mailing address
721 RIVER DR, SUITE A, FORT BRAGG, CA 95437
(707) 961-4631
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA64154
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/26/2022
Last updated
05/08/2024
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