Individual
JESSIE NICOLE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3600
Mailing address
110 ROANE ST, CHARLESTON, WV 25302-2334
(304) 344-0096
(304) 342-4725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
112552
WV
Other
Enumeration date
06/09/2017
Last updated
06/09/2017
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