Provider Demographics
NPI:1073270070
Name:WELCH, ASHLEY (APRN, NP-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 THE VILLAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-1612
Mailing Address - Country:US
Mailing Address - Phone:863-287-5354
Mailing Address - Fax:
Practice Address - Street 1:4935 SOUTHFORK DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2000
Practice Address - Country:US
Practice Address - Phone:863-646-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013202364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health