Provider Demographics
NPI:1427204486
Name:WELSH, NICOLE C (MD)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:C
Last Name:WELSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 PYRAMID WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-5060
Mailing Address - Country:US
Mailing Address - Phone:775-245-2373
Mailing Address - Fax:775-245-2374
Practice Address - Street 1:639 PYRAMID WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-5060
Practice Address - Country:US
Practice Address - Phone:775-245-2373
Practice Address - Fax:775-245-2375
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15673208000000X, 2084P0800X, 2084P0804X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV12541096OtherCAQH