Healthcare Provider Details

I. General information

NPI: 1376356907
Provider Name (Legal Business Name): ABIGAIL COLWELL WELCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 HALIFAX RD
EASLEY SC
29642-1932
US

IV. Provider business mailing address

114 HALIFAX RD
EASLEY SC
29642-1932
US

V. Phone/Fax

Practice location:
  • Phone: 864-607-3042
  • Fax:
Mailing address:
  • Phone: 864-607-3042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29907
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: