Doctor Name: | MATTHEW KELSEY WELLS |
NPI Number: | 1407112204 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | 2012006273 |
Business Practice Address: | 2703 Running Horse Rd. Platte City, MO - 640797077 |
Business Phone Number: | 8168587050 |
Business Fax Number: | 8168587055 |
Mailing Address: | 2703 Running Horse Rd., PLATTE CITY |
State: | MO |
Postal Code: | 640797077 |
Phone Number: | 8168587050 |
Fax Number: | 8168587055 |
NPI Enumeration Date: | 04/05/2012 |
NPI Last Update Date: | 04/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2012006273 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |