Healthcare Provider Details

I. General information

NPI: 1457701161
Provider Name (Legal Business Name): ALMA WELCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20439 E 650 RD
INOLA OK
74036-0000
US

IV. Provider business mailing address

20439 E 650 RD
INOLA OK
74036
US

V. Phone/Fax

Practice location:
  • Phone: 918-698-4913
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number14557701161
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: