Individual
BRENNA MAE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4240 HARRISON BLVD, OGDEN, UT 84403-3102
(801) 621-2610
Mailing address
6802 LEE HWY, CHATTANOOGA, TN 37421-2444
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
27174
TN
363LF0000X
Family Nurse Practitioner
9643056-4405
UT
390200000X
Student in an Organized Health Care Education/Training Program
SD-RN R040316
SD
Other
Enumeration date
08/18/2014
Last updated
04/28/2021
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