Provider Demographics
NPI:1841402062
Name:WELDIE, KRISTEN E (ATC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:E
Last Name:WELDIE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2126 ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2602
Mailing Address - Country:US
Mailing Address - Phone:610-630-8414
Mailing Address - Fax:
Practice Address - Street 1:414 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2618
Practice Address - Country:US
Practice Address - Phone:215-641-0700
Practice Address - Fax:215-641-0637
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0033862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA991391OtherNATA CERTIFICATION
PART003386OtherSTATE LICENSE