Provider Demographics
NPI:1356635171
Name:WELTON, CHRISTINA M (NP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:WELTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:WELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-730-6430
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:121 CAHILL RD STE 204
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-1911
Practice Address - Country:US
Practice Address - Phone:417-335-7222
Practice Address - Fax:417-335-7224
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011015336363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO426530705Medicaid
MO426530705Medicaid
MO148380037Medicare PIN
MO26D2006074OtherCLIA