Individual
JACOB NORMAN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-8899
(573) 341-5611
Mailing address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-8899
(573) 341-5611
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2019006750
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2024023273
MO
Other
Enumeration date
02/05/2024
Last updated
06/27/2024
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