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General NPI Number Information
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NPI Number | 1306430517
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Entity Type | Individual
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Provider Name | JANA LYNN WELCH FNP
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Gender | Female
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Dates
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Enumeration Date | 02/28/2021
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 1225 N STATE ST STE 103
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City | JACKSON
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State | MS
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Zip | 39202-2064
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Country | US
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Telephone | 769-268-6520
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CAMDEN WAY
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City | MADISON
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State | MS
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Zip | 39110-4112
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Country | US
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Telephone | 601-906-3437
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 904427
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License Number State | MS
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