Healthcare Provider Details

I. General information

NPI: 1700295672
Provider Name (Legal Business Name): EMILY WELSH PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 BILLERICA RD
CHELMSFORD MA
01824-3604
US

IV. Provider business mailing address

161 JACKSON ST
LOWELL MA
01852-2103
US

V. Phone/Fax

Practice location:
  • Phone: 978-250-6240
  • Fax:
Mailing address:
  • Phone: 978-746-7867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2280180
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: