Doctor Name: | MRS. JENNIFER MARIE WELLER |
NPI Number: | 1326330135 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.N. |
License Number: | 043.086635 |
Business Practice Address: | 306 46th Ave East Moline, IL - 612444281 |
Business Phone Number: | 3097962329 |
Business Fax Number: | 3097961146 |
Mailing Address: | 5444 10th Ave, MOLINE |
State: | IL |
Postal Code: | 612652731 |
Phone Number: | 3097816512 |
Fax Number: | |
NPI Enumeration Date: | 05/11/2011 |
NPI Last Update Date: | 05/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 043.086635 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |