Provider Demographics
NPI:1669995668
Name:WELLS, ADRIANNE (BSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 TRUMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-2529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 SPRUCE ST
Practice Address - Street 2:DUNCAN BUILDING SUITE B3
Practice Address - City:PHILADELPHIA
Practice Address - State:NJ
Practice Address - Zip Code:19104-1910
Practice Address - Country:US
Practice Address - Phone:215-829-5046
Practice Address - Fax:215-829-3043
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR14098500163WL0100X
PAL-84783163WL0100X
PARN688399163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant