Healthcare Provider Details

I. General information

NPI: 1235455064
Provider Name (Legal Business Name): BARBARA SHEHAN WELTY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS BARBARA JOAN SHEHAN

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 05/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N PALM CANYON DR SUITE 212
PALM SPRINGS CA
92262-4414
US

IV. Provider business mailing address

42335 WASHINGTON ST SUITE F
PALM DESERT CA
92211-8031
US

V. Phone/Fax

Practice location:
  • Phone: 760-327-7900
  • Fax: 760-327-7905
Mailing address:
  • Phone: 760-345-5390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number500829
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: