Healthcare Provider Details

I. General information

NPI: 1609707801
Provider Name (Legal Business Name): NATHANIEL WELSH RN, BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 SERENE CT
IRMO SC
29063-7792
US

IV. Provider business mailing address

412 SERENE CT
IRMO SC
29063-7792
US

V. Phone/Fax

Practice location:
  • Phone: 803-807-0099
  • Fax:
Mailing address:
  • Phone: 803-807-0099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number238793
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: