Provider Demographics
NPI:1316836869
Name:WELTY, TINA LAURELL
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:LAURELL
Last Name:WELTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 ELK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3368
Mailing Address - Country:US
Mailing Address - Phone:402-217-3789
Mailing Address - Fax:
Practice Address - Street 1:9725 CASA GALEANO CT
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68520-1518
Practice Address - Country:US
Practice Address - Phone:402-217-3789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care