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NPI Code Detail

MEDICARE: CARRIE JENNIFER WELTER NP-C

MEDICARE: CARRIE JENNIFER WELTER 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
1363LF0000XFamily Nurse Practitioner5532535-4405UT

General Provider Information

NPI Number : 1518447648
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE JENNIFER WELTER NP-C
Provider Business Mailing Address
First Line : 3162 E SAGEBRUSH CIR
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-4318
Country : US
Telephone Number : 904-477-7579
Fax Number :
Provider Business Practice Location Address
First Line : 1784 UINTA WAY UNIT E2
Second Line :
City : PARK CITY
State : UT
Zip : 84098-7685
Country : US
Telephone Number : 435-604-0160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2018
Last Update Date : 08/17/2018

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Directions to “ CARRIE JENNIFER WELTER NP-C” Practice Location

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