| Doctor Name: | MR. JAMIE WELLS |
| NPI Number: | 1568881217 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-BC |
| License Number: | RN140888 |
| Business Practice Address: | 7300 Ga Highway 21 Port Wentworth, GA - 314079205 |
| Business Phone Number: | 9129641797 |
| Business Fax Number: | |
| Mailing Address: | 121 Lakewood Dr, GUYTON |
| State: | GA |
| Postal Code: | 313126562 |
| Phone Number: | 9123086619 |
| Fax Number: | |
| NPI Enumeration Date: | 04/09/2014 |
| NPI Last Update Date: | 04/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN140888 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |