Provider Demographics
NPI:1396978227
Name:WELTON, DEBRA NORWOOD (FNP-C)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:NORWOOD
Last Name:WELTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:KAY
Other - Last Name:WELTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:4600 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77023-3548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3825 GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-5725
Practice Address - Country:US
Practice Address - Phone:225-387-1167
Practice Address - Fax:404-494-7435
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN100496163W00000X
LAAPO5922363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1801607Medicaid