Provider Demographics
NPI:1881436616
Name:WELCH, ELIZABETH JANE (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:WELCH
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4341 KNOX AVE
Mailing Address - Street 2:
Mailing Address - City:ROSAMOND
Mailing Address - State:CA
Mailing Address - Zip Code:93560-6426
Mailing Address - Country:US
Mailing Address - Phone:316-670-3394
Mailing Address - Fax:
Practice Address - Street 1:44215 15TH ST W STE 209
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5504
Practice Address - Country:US
Practice Address - Phone:661-522-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030973363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner