MRS. KELLIE MARIE WELLS (NPI# 1700832987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700832987 |
Entity Type | Individual |
Full Name | MRS. KELLIE MARIE WELLS |
Credential | PA |
Practice Address |
1200 E Michigan Ave Ste 415 Lansing MI 48912-1897 |
Practice Telephone | 5174842760 |
Practice Fax Number | 5174849370 |
Mailing Telephone | 5174842760 |
Mailing Fax Number | 5174849370 |
Enumeration Date | 2006-05-26 |
Last Update Date | 2013-01-21 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
363AM0700X | MI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | BCBS STATE LICENSE | 5601004711 | 01 |
Street Address |
1200 E MICHIGAN AVE STE 415 |
City | LANSING |
State | MI |
Zip Code | 48912-1897 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629555768 | Andrew John Palmer | Nurse Practitioner | 1200 E Michigan Ave Ste 415, Lansing, MI 48912-1858 | 2018-07-22 |
1871987537 | Jonathan Thomas Mcfarland | Internal Medicine | 1200 E Michigan Ave Ste 415, Lansing, MI 48912-1858 | 2015-03-20 |
1194002550 | Michael W Masnyj | Internal Medicine | 1200 E Michigan Ave Ste 415, Lansing, MI 48912 | 2011-11-12 |
1023230448 | Saniya Khan | Specialist | 1200 E Michigan Ave Ste 415, Lansing, MI 48912-1897 | 2007-05-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316563646 | Shelley Gabel | Surgery | 1200 E Michigan Ave., Sparrow Professional Building Suite 655, Lansing, MI 48912 | 2020-06-23 |
1568087237 | Ahmed Mohamed Haggag | Student in an Organized Health Care Education/Training Program | 1215 East Michigan Avenue 3rd Floor, Lansing, MI 48912 | 2020-06-09 |
1467074773 | Craig Hargurkirat Malli | Family Medicine | 1215 E Michigan Avenue Suite 245, Lansing, MI 48912 | 2020-05-08 |
1215558945 | Temmy J. Brotherson | Family Medicine | Sparrow Health Systems, 1200 E Michigan Avenues, Suite 245, Lansing, MI 48912 | 2020-05-05 |
1386265452 | Kyle Patrick Doran | Emergency Medicine | Sparrow Health System, 1215 E Michigan Avenue, Lansing, MI 48912 | 2020-04-30 |
1316418841 | Andrea Mcswain Do PC | Obstetrics & Gynecology | 1909 E. Michigan Ave, Lansing, MI 48912 | 2018-12-10 |
1215386115 | Michael Vernon Hollis | Student in an Organized Health Care Education/Training Program | 1500 E Michigan Ave, Suite 655, Lansing, MI 48912 | 2016-06-10 |
1518333970 | Eastside Community Action Center | Social Worker | 1001 Dakin Street, Suite B, Lansing, MI 48912 | 2015-08-19 |
1649667403 | Cheryl Ann Wade | Counselor | 1712 E Michigan Ave., Lansing, MI 48912 | 2015-04-20 |
1083006134 | Carol Pratt | Occupational Therapist | 1200 E. Michigan Ave, Outpatient Rehab - Lower Level, Lansing, MI 48912 | 2015-02-26 |
Find all providers in zip 48912 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144479148 | Michelle Gormas | Physician Assistant | 2722 E Michigan Ave, Lansing, MI 48912-4037 | 2008-09-15 |
1093979270 | Denise Michelle Burroughs | Physician Assistant | 5135 S Penn Ave, Lansing, MI 48911-4002 | 2008-07-16 |
1366580417 | George Roland Over | Physician Assistant | 1115 S Pennsylvania Ave, Lansing, MI 48912-1669 | 2007-02-01 |
1831278092 | Anne Margaret Teremi | Physician Assistant | 4202 Collins Rd, Suite 115, Lansing, MI 48910-5894 | 2006-11-06 |
1780648667 | Walter Herbert Grumbt | Physician Assistant | 129 Brookwood Ct, Lansing, KS 66043-1557 | 2006-04-17 |
1841299617 | J Charles Elliott | Physician Assistant | 416 S Creyts Rd, Lansing, MI 48917-8290 | 2005-07-14 |
1013568500 | Elizabeth K Holsclaw | Physician Assistant | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2019-09-25 |
1194288720 | Adriana Maria Ledesma | Physician Assistant | 505 N Clippert St, Lansing, MI 48912-4701 | 2019-04-10 |
1043745730 | Degara App Hm, Pllc | Physician Assistant | 401 W Greenlawn Ave, Lansing, MI 48910-2819 | 2017-05-01 |
1770018269 | Kaitlyn Haley Kimmel | Physician Assistant | 505 N Clippert St, Lansing, MI 48912-4701 | 2017-04-22 |
Find all providers in LANSING |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.