Healthcare Provider Details

I. General information

NPI: 1073393559
Provider Name (Legal Business Name): ASHLEY ELIZABETH WELSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 SUDBURY DR
KETTERING OH
45420-1129
US

IV. Provider business mailing address

2469 SUNSET MAPLE DR
TIPP CITY OH
45371-1590
US

V. Phone/Fax

Practice location:
  • Phone: 126-993-7310
  • Fax:
Mailing address:
  • Phone: 937-776-9710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number134892
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: