Provider Demographics
NPI:1053982595
Name:WELLS, AUDRIAN MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:AUDRIAN
Middle Name:MARIE
Last Name:WELLS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:160 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-2010
Mailing Address - Country:US
Mailing Address - Phone:914-821-7307
Mailing Address - Fax:914-681-8927
Practice Address - Street 1:1210 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-4208
Practice Address - Country:US
Practice Address - Phone:646-612-7747
Practice Address - Fax:646-627-7219
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF346245363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily