MEDICARE: MELISSA ELICIA WELCH NP

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
1	363L00000X	Nurse Practitioner	APRN.CNP.0034997	OH
2	363L00000X	Nurse Practitioner	359112	NY
3	363LF0000X	Family Nurse Practitioner	4704254903	MI
4	363LF0000X	Family Nurse Practitioner	71010299A	IN
5	363LF0000X	Family Nurse Practitioner	APRN.CNP.0034997	OH
6	363L00000X	Nurse Practitioner	71010299A	IN

General Provider Information

NPI Number	:	1912398454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ELICIA WELCH NP

Provider Business Mailing Address
First Line	:	9530 DAUGHERTY RD
Second Line	:
City	:	BROOKLYN
State	:	MI
Zip	:	49230-9111
Country	:	US
Telephone Number	:	313-618-4391
Fax Number	:

Provider Business Practice Location Address
First Line	:	10146 E OLD VAIL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85747-9406
Country	:	US
Telephone Number	:	520-574-7400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2015
Last Update Date	:	03/13/2026

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