Healthcare Provider Details

I. General information

NPI: 1053513549
Provider Name (Legal Business Name): LINDA LEE WELTER REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STARR CENTER PACE PRESCHOOL PROGRAM 102 N. PLUMER
TUCSON AZ
85719
US

IV. Provider business mailing address

7330 N YUCCA VIA
TUCSON AZ
85704-6227
US

V. Phone/Fax

Practice location:
  • Phone: 520-225-3227
  • Fax: 520-225-3268
Mailing address:
  • Phone: 520-797-0659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN064198
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: