Provider Demographics
NPI:1528214541
Name:WELCH, MELISSA LEA (APRN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEA
Last Name:WELCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LEA
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:423 FORTRESS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-1351
Mailing Address - Country:US
Mailing Address - Phone:304-225-2500
Mailing Address - Fax:304-985-6390
Practice Address - Street 1:1001 CONSOL ENERGY DRIVE
Practice Address - Street 2:
Practice Address - City:CONOSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317
Practice Address - Country:US
Practice Address - Phone:304-720-5126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-10
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV55837363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP32781Medicare PIN