MEDICARE: MRS. MALINDA MASON WELFORD CRNP

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	363LA2100X	Acute Care Nurse Practitioner	1-091498	AL

General Provider Information

NPI Number	:	1851560817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MALINDA MASON WELFORD CRNP

Provider Business Mailing Address
First Line	:	4621 MORRISON DR
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36609-3353
Country	:	US
Telephone Number	:	251-344-7474
Fax Number	:	251-344-1622

Provider Business Practice Location Address
First Line	:	4621 MORRISON DR
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36609-3353
Country	:	US
Telephone Number	:	251-344-7474
Fax Number	:	251-344-1622

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

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	09/11/2008

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