Provider Demographics
NPI:1467718288
Name:WELKER, LISA K (NP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:K
Last Name:WELKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 N SCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-1730
Mailing Address - Country:US
Mailing Address - Phone:816-322-4769
Mailing Address - Fax:816-322-3508
Practice Address - Street 1:503 N SCOTT AVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-1730
Practice Address - Country:US
Practice Address - Phone:816-322-4769
Practice Address - Fax:816-322-3508
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100568363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics