Provider Demographics
NPI:1033217575
Name:WELKER, JEANETTE L (RN, FNP)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:L
Last Name:WELKER
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 EXECUTIVE PKWY
Mailing Address - Street 2:STE 360
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2169
Mailing Address - Country:US
Mailing Address - Phone:541-759-2828
Mailing Address - Fax:
Practice Address - Street 1:1200 EXECUTIVE PKWY
Practice Address - Street 2:SUITE 360
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2114
Practice Address - Country:US
Practice Address - Phone:541-344-4594
Practice Address - Fax:541-686-6295
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDN-14409 NP-207A363LF0000X
OR200650163NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily