Provider Demographics
NPI:1659708253
Name:WELKER, CATHEY (PA-C)
Entity Type:Individual
Prefix:
First Name:CATHEY
Middle Name:
Last Name:WELKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 SOUTH BOULEVARD
Mailing Address - Street 2:SUITE 18B
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5487
Mailing Address - Country:US
Mailing Address - Phone:405-822-6304
Mailing Address - Fax:405-378-2063
Practice Address - Street 1:3500 S BOULEVARD
Practice Address - Street 2:SUITE 18B
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5486
Practice Address - Country:US
Practice Address - Phone:405-822-6304
Practice Address - Fax:405-378-2063
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPA 938363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant