Provider Demographics
NPI:1265264972
Name:WELTER, KATHERINE IRENE (NP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:IRENE
Last Name:WELTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 MONTAGUE ST APT 33E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3625
Mailing Address - Country:US
Mailing Address - Phone:781-608-2723
Mailing Address - Fax:
Practice Address - Street 1:180 MONTAGUE ST APT 33E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3625
Practice Address - Country:US
Practice Address - Phone:781-608-2723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF406150363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health