Healthcare Provider Details

I. General information

NPI: 1780636001
Provider Name (Legal Business Name): PATTI A. WELCH RN-BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2814 W 15TH ST
PANAMA CITY FL
32401-1376
US

IV. Provider business mailing address

5832 HIGH POINT RD
PANAMA CITY FL
32404-4203
US

V. Phone/Fax

Practice location:
  • Phone: 850-872-4840
  • Fax: 850-872-4468
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN-1490132
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: