Provider Demographics
NPI:1811910003
Name:WELCH, JOAN A (NP)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:A
Last Name:WELCH
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 1:6 GREEN CIR REAR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-3425
Mailing Address - Country:US
Mailing Address - Phone:203-733-7958
Mailing Address - Fax:
Practice Address - Street 1:44 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-8047
Practice Address - Country:US
Practice Address - Phone:203-744-2938
Practice Address - Fax:203-790-4735
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001043363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health