MEDICARE: KATHRYN A WELCH PA-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	363AM0700X	Medical Physician Assistant	15-00659	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	042558	OTHER	KS	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336142116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN A WELCH PA-C

Provider Business Mailing Address
First Line	:	220 S HILLSIDE ST STE A
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67211-2151
Country	:	US
Telephone Number	:	316-686-6866
Fax Number	:	316-686-9797

Provider Business Practice Location Address
First Line	:	220 S HILLSIDE ST STE A
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67211-2151
Country	:	US
Telephone Number	:	316-686-6866
Fax Number	:	316-686-9797

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	12/02/2019

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