Individual
MS. JAN ELLEN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
109 N FAIRLAND ST, SUITE 104, PRYOR, OK 74361-4203
(918) 824-4424
(918) 824-4474
Mailing address
109 N FAIRLAND ST, SUITE 104, PRYOR, OK 74361-4203
(918) 824-4424
(918) 824-4474
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0027163
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094230
—
OK
Enumeration date
12/19/2005
Last updated
05/31/2011
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