Provider Demographics
NPI:1811018419
Name:WELMAN, ANNA CATHARINA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:CATHARINA
Last Name:WELMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 SUMMIT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-9101
Mailing Address - Country:US
Mailing Address - Phone:870-897-2864
Mailing Address - Fax:870-935-1061
Practice Address - Street 1:4604 SUMMIT RIDGE DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9101
Practice Address - Country:US
Practice Address - Phone:870-897-2864
Practice Address - Fax:870-935-1061
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT1361225100000X
AZ6914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5T771OtherAR BLUE CROSS BLUE SHIELD