Provider Demographics
NPI:1629476072
Name:WELCH, DEANNA MICHELLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:MICHELLE
Last Name:WELCH
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:8 BURNHAM STREET
Practice Address - Street 2:
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1816
Practice Address - Country:US
Practice Address - Phone:413-774-3751
Practice Address - Fax:413-773-1398
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2020-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN2284709363LG0600X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health