Healthcare Provider Details

I. General information

NPI: 1811910003
Provider Name (Legal Business Name): JOAN A WELCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 MAIN ST
DANBURY CT
06810-8047
US

IV. Provider business mailing address

6 GREEN CIR REAR
WOODBURY CT
06798-3425
US

V. Phone/Fax

Practice location:
  • Phone: 203-744-2938
  • Fax: 203-790-4735
Mailing address:
  • Phone: 203-733-7958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number001043
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: