Healthcare Provider Details

I. General information

NPI: 1407392871
Provider Name (Legal Business Name): KEISHA ANIECE WELSH R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12919 BARKLEY BEND LANE
HOUSTON TX
77044
US

IV. Provider business mailing address

P.O. BOX 105
HUFFMAN TX
77336
US

V. Phone/Fax

Practice location:
  • Phone: 832-563-3878
  • Fax:
Mailing address:
  • Phone: 832-563-3878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number813181
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number813181
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number813181
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number813181
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number813181
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number813181
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: