Provider Demographics
NPI:1346585676
Name:WELCH, CATHERINE ESTELLE (LPN)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ESTELLE
Last Name:WELCH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1066 COUNTY ROUTE 8
Mailing Address - Street 2:LOT 4
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-4735
Mailing Address - Country:US
Mailing Address - Phone:315-806-9764
Mailing Address - Fax:
Practice Address - Street 1:1066 COUNTY ROUTE 8
Practice Address - Street 2:LOT 4
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-4735
Practice Address - Country:US
Practice Address - Phone:315-806-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264108-13747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider