Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | A005836 | AR |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | A005836 | AR |
NPI | 1003395427 |
---|---|
Provider Name | Steven A. Wells |
First Address | Lavaca, AR 72941-3775 |
Second Address | Fort Smith, AR 72903-4100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2018 |
Last Update Date | 30/09/2021 |