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NPI Code Detail

MEDICARE: PENNY L WELKER

MEDICARE:   PENNY L WELKER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner19412TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174921258
Entity Type Code : Individual
Provider Name (Legal Business Name) : PENNY L WELKER
Provider Business Mailing Address
First Line : 1004 N HIGHWAY 92 STE B
Second Line :
City : JEFFERSON CITY
State : TN
Zip : 37760-3687
Country : US
Telephone Number : 865-647-3400
Fax Number : 865-647-3401
Provider Business Practice Location Address
First Line : 1004 N HIGHWAY 92 STE B
Second Line :
City : JEFFERSON CITY
State : TN
Zip : 37760-3687
Country : US
Telephone Number : 865-647-3400
Fax Number : 865-647-3401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2014
Last Update Date : 11/08/2024

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Directions to “ PENNY L WELKER ” Practice Location

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