MEDICARE: DEBBIE WELCH NP-C

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
1	363LF0000X	Family Nurse Practitioner	95001662	CA
2	363LF0000X	Family Nurse Practitioner	NUR-APRN-LIC-194006	MT

General Provider Information

NPI Number	:	1194118836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBIE WELCH NP-C

Provider Business Mailing Address
First Line	:	PO BOX 12
Second Line	:
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99019-0012
Country	:	US
Telephone Number	:	406-777-5522
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 MAIN ST
Second Line	:
City	:	STEVENSVILLE
State	:	MT
Zip	:	59870-2846
Country	:	US
Telephone Number	:	406-777-5522
Fax Number	:	406-777-1175

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	04/18/2022

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