Individual
WESLEY WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758
(479) 338-8000
Mailing address
PO BOX 507, LOWELL, AR 72745-0507
(678) 690-8332
(678) 992-1463
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2014006195
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
C003159
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200790330A
—
OK
05
—
215761001
—
AR
01
—
5BZ36
BCBS ARKANSAS
AR
05
—
910070613
—
MO
01
—
P02077944
RAILROAD
AR
Enumeration date
04/22/2016
Last updated
06/18/2021
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