Provider Demographics
NPI:1891046702
Name:WELKER, JESSICA RAE (MSED)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:RAE
Last Name:WELKER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-3253
Mailing Address - Country:US
Mailing Address - Phone:585-344-4404
Mailing Address - Fax:
Practice Address - Street 1:45 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-3253
Practice Address - Country:US
Practice Address - Phone:585-344-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist