| NPI | 1679964019 | 
|---|---|
| Former Name | GINGER NICHOLE WELLS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK R0077265)  | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: OK R0077265)  | 
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP61333001)  | |
| Enumeration Date | 2015-02-06 | 
| Last Update Date | 2022-08-12 |