Healthcare Provider Details

I. General information

NPI: 1861880577
Provider Name (Legal Business Name): KRISTINA A WELDEN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINA A PARKER CRNP

II. Dates (important events)

Enumeration Date: 01/03/2015
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29810 AL HIGHWAY 71
BRYANT AL
35958-5240
US

IV. Provider business mailing address

12978 N MAIN ST
TRENTON GA
30752-2241
US

V. Phone/Fax

Practice location:
  • Phone: 256-597-4114
  • Fax: 256-597-4115
Mailing address:
  • Phone: 706-657-4183
  • Fax: 706-657-4270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-130421
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: