Provider Demographics
NPI:1699144303
Name:WELLS, CHRISTINA LYNN (FNP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:LYNN
Last Name:WELLS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-7216
Mailing Address - Fax:314-696-1391
Practice Address - Street 1:1418 CROSS ST
Practice Address - Street 2:DIV WUPI HEMATOLOGY, STE 180
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62269-2914
Practice Address - Country:US
Practice Address - Phone:314-362-7216
Practice Address - Fax:314-696-1391
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023830363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420155582Medicaid