Provider Demographics
NPI:1972037075
Name:WELCH, MAUREEN (RN)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:WELCH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 MENTOR AVENUE
Mailing Address - Street 2:BEACON HEALTH
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6412
Mailing Address - Country:US
Mailing Address - Phone:440-639-3509
Mailing Address - Fax:440-205-1009
Practice Address - Street 1:9220 MENTOR AVENUE
Practice Address - Street 2:BEACON HEALTH
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6412
Practice Address - Country:US
Practice Address - Phone:440-639-3509
Practice Address - Fax:440-205-1009
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN319148163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse