Provider Demographics
NPI:1336566546
Name:WELCH, KRISTEN MOTLOW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MOTLOW
Last Name:WELCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 OLD SALEM WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-9077
Mailing Address - Country:US
Mailing Address - Phone:706-840-2903
Mailing Address - Fax:
Practice Address - Street 1:10 POPE AVE
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-4719
Practice Address - Country:US
Practice Address - Phone:843-785-7786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13272183500000X
GA025466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist