Healthcare Provider Details

I. General information

NPI: 1730116484
Provider Name (Legal Business Name): KAREN MISHRELL WELCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 STEUBEN ST
MONTOUR FALLS NY
14865-9648
US

IV. Provider business mailing address

230 STEUBEN ST
MONTOUR FALLS NY
14865-9648
US

V. Phone/Fax

Practice location:
  • Phone: 607-535-8639
  • Fax: 607-535-7157
Mailing address:
  • Phone: 607-535-8639
  • Fax: 607-535-7157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number330550
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: