Healthcare Provider Details

I. General information

NPI: 1619670064
Provider Name (Legal Business Name): RACHEL NICOLE WELSH DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 W JEFFERSON BLVD STE 150
FORT WAYNE IN
46804-4133
US

IV. Provider business mailing address

7601 W JEFFERSON BLVD STE 150
FORT WAYNE IN
46804-4133
US

V. Phone/Fax

Practice location:
  • Phone: 800-566-5659
  • Fax: 260-436-8585
Mailing address:
  • Phone: 800-566-5659
  • Fax: 260-436-8585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number07001524A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: