MEDICARE: MRS. NATASHA N WELCH-TYNER LPN

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	164W00000X	Licensed Practical Nurse	121663	OH

General Provider Information

NPI Number	:	1851509533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATASHA N WELCH-TYNER LPN

Provider Business Mailing Address
First Line	:	3216 EUCLID HEIGHTS BLVD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-1876
Country	:	US
Telephone Number	:	216-926-8089
Fax Number	:

Provider Business Practice Location Address
First Line	:	3216 EUCLID HEIGHTS BLVD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-1876
Country	:	US
Telephone Number	:	216-926-8089
Fax Number	:

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

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	07/08/2007

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