Provider Demographics
NPI:1558831255
Name:WELDER, JANA (FNP-C)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:WELDER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7520 MONTGOMERY BLVD NE BLDG D4
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1533
Mailing Address - Country:US
Mailing Address - Phone:505-677-8343
Mailing Address - Fax:505-677-8355
Practice Address - Street 1:7520 MONTGOMERY BLVD NE BLDG D4
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1533
Practice Address - Country:US
Practice Address - Phone:505-677-8343
Practice Address - Fax:505-677-8355
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM54606207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM54606OtherNEW MEXICO BOARD OF NURSING
NM02273586Medicaid