Provider Demographics
NPI:1184162059
Name:WELSH, TARA (CRNP)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:WELSH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 INDUSTRIAL PARK RD STE 1500
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-8153
Mailing Address - Country:US
Mailing Address - Phone:724-689-1822
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:4000 HEMPFIELD PLAZA BLVD STE 963
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1485
Practice Address - Country:US
Practice Address - Phone:724-832-9000
Practice Address - Fax:724-832-9303
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily