Healthcare Provider Details

I. General information

NPI: 1851631410
Provider Name (Legal Business Name): DEBORAH D WELSH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 KENTUCKY AVE STE 304
PADUCAH KY
42003-3829
US

IV. Provider business mailing address

2700 STANLEY GAULT PKWY STE 129
LOUISVILLE KY
40223-5176
US

V. Phone/Fax

Practice location:
  • Phone: 270-415-4800
  • Fax: 270-415-4801
Mailing address:
  • Phone: 502-253-4900
  • Fax: 502-489-5751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number3006220
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: