Healthcare Provider Details

I. General information

NPI: 1356377097
Provider Name (Legal Business Name): WELSH FAMILY PRACTICE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 PALMER ST
WELSH LA
70591-4320
US

IV. Provider business mailing address

308 PALMER ST P.O. BOX 605
WELSH LA
70591-4320
US

V. Phone/Fax

Practice location:
  • Phone: 337-734-4901
  • Fax: 337-734-4338
Mailing address:
  • Phone: 337-734-4901
  • Fax: 337-734-4338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA BERTRAND
Title or Position: OFFICE MANAAGER
Credential:
Phone: 337-734-4901