Provider Demographics
NPI:1659641454
Name:WELSH, SUSAN D (CNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:D
Last Name:WELSH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:D
Other - Last Name:LOCKAMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1225 RONA PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-5738
Mailing Address - Country:US
Mailing Address - Phone:937-878-4046
Mailing Address - Fax:
Practice Address - Street 1:33 W RAHN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2219
Practice Address - Country:US
Practice Address - Phone:937-433-8990
Practice Address - Fax:937-433-8691
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.13016-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care