Wells, Kelli Tice
Wells, Kelli Tice is an individual health care provider with primary practice located at 1295 W Fairfield Dr , Pensacola FL 32501-1107. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Wells, Kelli Tice can be contacted via phone (850) 595-6500.Contact Information
Primary practice address
1295 W Fairfield Dr
Pensacola FL 32501-1107
Phone: (850) 595-6500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | ME82944 | Florida |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME82944 | Florida |
Profile Details
| NPI number | 1972593820 |
|---|---|
| LBN Legal business name | Wells, Kelli Tice |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Dec 12th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972593820 | NPPES |
| Alabama | MEDICAID | 009978895 | |
| Alabama | Other | 59176263 | |
| Alabama | MEDICAID | 262522900 | |
| Alabama | Other | 06241 | |
| Alabama | Other | P00195990 | |
| Alabama | Other | 7804499 |
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