Individual
MARY WELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 KEEWAYDIN DR, SALEM, NH 03079-2839
(505) 863-9551
Mailing address
4240 MYSTERY CT, SPARKS, NV 89436-7178
(775) 848-8745
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN07160
NV
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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