Provider Demographics
NPI:1841658317
Name:WELCH, ALLISON (NP-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 EATONTON RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:GA
Mailing Address - Zip Code:30650-4627
Mailing Address - Country:US
Mailing Address - Phone:706-752-0322
Mailing Address - Fax:706-752-0325
Practice Address - Street 1:1550 EATONTON RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650-4627
Practice Address - Country:US
Practice Address - Phone:706-752-0322
Practice Address - Fax:706-752-0325
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN213033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily