Provider Demographics
NPI:1356844468
Name:WELCH, VERONICA VASSILEV (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:VASSILEV
Last Name:WELCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:VERONICA
Other - Middle Name:CHRISTINE
Other - Last Name:VASSILEV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:301 RIVERVIEW AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1065
Mailing Address - Country:US
Mailing Address - Phone:757-261-0700
Mailing Address - Fax:
Practice Address - Street 1:301 RIVERVIEW AVE STE 700
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1065
Practice Address - Country:US
Practice Address - Phone:757-261-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
VA0110006190363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical