Provider Demographics
NPI:1447050406
Name:WELLS, TEIAH
Entity type:Individual
Prefix:
First Name:TEIAH
Middle Name:
Last Name:WELLS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12052 MARY CT APT 13A
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68142-1857
Mailing Address - Country:US
Mailing Address - Phone:945-426-8657
Mailing Address - Fax:
Practice Address - Street 1:12052 MARY CT APT 13A
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68142-1857
Practice Address - Country:US
Practice Address - Phone:945-426-8657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide