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NPI Code Detail

MEDICARE: CHERYL J WELTMAN CPNP

MEDICARE:   CHERYL J WELTMAN  CPNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner231159TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11750369203OTHERGRP NPI NUMBER

General Provider Information

NPI Number : 1184712929
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL J WELTMAN CPNP
Provider Business Mailing Address
First Line : PO BOX 99371
Second Line :
City : FORT WORTH
State : TX
Zip : 76199-0371
Country : US
Telephone Number : 682-885-1855
Fax Number : 682-885-7347
Provider Business Practice Location Address
First Line : 2755 MILLER AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76105-4164
Country : US
Telephone Number : 817-534-7110
Fax Number : 817-413-0521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 04/20/2010

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