Individual
TIFFANY EILEEN WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2434
(208) 750-7507
(208) 750-7384
Mailing address
415 6TH STREET, ATTN: PHYSICIAN SERVICES, LEWISTON, ID 83501-2434
(208) 750-7462
(208) 750-7467
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
74327
ID
363LF0000X
Family Nurse Practitioner
RN198187
GA
Other
Enumeration date
10/13/2017
Last updated
12/27/2024
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