Provider Demographics
NPI:1760600589
Name:WELCH, GEORGEANNA L (NP FNPC)
Entity Type:Individual
Prefix:MS
First Name:GEORGEANNA
Middle Name:L
Last Name:WELCH
Suffix:
Gender:F
Credentials:NP FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 22ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1308
Mailing Address - Country:US
Mailing Address - Phone:806-799-4192
Mailing Address - Fax:
Practice Address - Street 1:3502 22ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1308
Practice Address - Country:US
Practice Address - Phone:806-799-4192
Practice Address - Fax:806-799-6299
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX544999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206176401Medicaid
TX8Y9526OtherBCBS
TXP00743584OtherMEDICARE RR
TXQ45552Medicare UPIN
TX206176401Medicaid