Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 54317 | MN |
N | 111NI0900X | Internist | 54317 | MN |
N | 207RR0500X | Rheumatology | 2013-00259 | NC |
Y | 207RR0500X | Rheumatology | 48288 | IA |
N | 207RR0500X | Rheumatology | DR.0056562 | CO |
NPI | 1134440886 |
---|---|
Provider Name | Melissa Ann Wells |
First Address | Ames, IA 50010-5469 |
Second Address | Ames, IA 50010-8676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 01/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35135107 | (05) | CO |