Provider Demographics
NPI:1710066055
Name:WELCH, LINDA CATHERINE (RNC, MSN, WHCNP, FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:CATHERINE
Last Name:WELCH
Suffix:
Gender:F
Credentials:RNC, MSN, WHCNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 VILLAGE TRL E UNIT 6
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5820
Mailing Address - Country:US
Mailing Address - Phone:612-465-9270
Mailing Address - Fax:
Practice Address - Street 1:1675 VILLAGE TRL E UNIT 6
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-5820
Practice Address - Country:US
Practice Address - Phone:612-465-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1563698363LX0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN915823500Medicaid
MN915823500Medicaid
MNS45993Medicare UPIN