Provider Demographics
NPI:1043049034
Name:THE WELL PSYCHIATRIC CARE, LLC
Entity type:Organization
Organization Name:THE WELL PSYCHIATRIC CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WIEBE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-737-0516
Mailing Address - Street 1:605 AUTUMN GLEN CT
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-9007
Mailing Address - Country:US
Mailing Address - Phone:316-737-0516
Mailing Address - Fax:
Practice Address - Street 1:1023 WASHINGTON RD STE F
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-4415
Practice Address - Country:US
Practice Address - Phone:316-737-0516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty