| Welllife House Calls | |
|
211 E Six Forks Rd Suite 122 Raleigh NC 27609-7745 | |
| (919) 829-1315 | |
| Not Available |
| Full Name | Welllife House Calls |
|---|---|
| Speciality | Clinic/Center |
| Location | 211 E Six Forks Rd, Raleigh, North Carolina |
| Authorized Official Name and Position | Dwan Kelsey (OWNER) |
| Authorized Official Contact | 9198291315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Welllife House Calls 211 E Six Forks Rd Suite 122 Raleigh NC 27609-7745 | Welllife House Calls 211 E Six Forks Rd Suite 122 Raleigh NC 27609-7745 Ph: (919) 829-1315 |
| NPI Number | 1497010771 |
|---|---|
| Provider Enumeration Date | 07/11/2012 |
| Last Update Date | 07/11/2012 |
| Medicare PECOS PAC ID | 8123533841 |
|---|---|
| Medicare Enrollment ID | O20250711003670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497010771 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 136549 (North Carolina) | Primary |
| Provider Name | Dwan T Kelsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629297429 PECOS PAC ID: 8921060203 Enrollment ID: I20041029000060 |
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