Individual
SHANTAY LATOYA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-4474
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-4474
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
006270
CT
Other
Enumeration date
10/07/2015
Last updated
11/18/2022
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