Provider Demographics
NPI:1609500636
Name:SPEARS, WELTY ALINA (RN)
Entity Type:Individual
Prefix:MS
First Name:WELTY
Middle Name:ALINA
Last Name:SPEARS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MOHAWK ROAD
Mailing Address - Street 2:SUITES D AND E
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34715
Mailing Address - Country:US
Mailing Address - Phone:352-989-5766
Mailing Address - Fax:
Practice Address - Street 1:230 MOHAWK ROAD
Practice Address - Street 2:SUITES D AND E
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34715
Practice Address - Country:US
Practice Address - Phone:352-989-5766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL935347163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health