Provider Demographics
NPI:1710673827
Name:WELSH, SHAWNA KELLIE (RN)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:KELLIE
Last Name:WELSH
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 1:1169 SOUTHWIND DR
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-2644
Mailing Address - Country:US
Mailing Address - Phone:785-350-4670
Mailing Address - Fax:785-350-4688
Practice Address - Street 1:1169 SOUTHWIND DR
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-2644
Practice Address - Country:US
Practice Address - Phone:785-350-4670
Practice Address - Fax:785-350-4688
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-63428163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care