Provider Demographics
NPI:1164318051
Name:WELLS, ANGELA YVETTE
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:YVETTE
Last Name:WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:YVETTE
Other - Last Name:SPEARS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:5782 BAYAKOA RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-1854
Mailing Address - Country:US
Mailing Address - Phone:702-986-5794
Mailing Address - Fax:
Practice Address - Street 1:5782 BAYAKOA RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-1854
Practice Address - Country:US
Practice Address - Phone:702-986-5794
Practice Address - Fax:702-986-5794
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV889666163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health