Provider Demographics
NPI:1588662795
Name:WELK, DEBRA C (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:C
Last Name:WELK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 39
Mailing Address - Street 2:54 FRANKLIN ST, STE 104
Mailing Address - City:WEYERS CAVE
Mailing Address - State:VA
Mailing Address - Zip Code:24486-2340
Mailing Address - Country:US
Mailing Address - Phone:540-234-0080
Mailing Address - Fax:540-234-8688
Practice Address - Street 1:54 FRANKLIN ST
Practice Address - Street 2:STE 104
Practice Address - City:WEYERS CAVE
Practice Address - State:VA
Practice Address - Zip Code:24486-2340
Practice Address - Country:US
Practice Address - Phone:540-234-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7310773Medicaid
VAMW1161481OtherDEA NUMBER
VA7310773Medicaid