Provider Demographics
NPI:1073493425
Name:WELCH, HEIDI LEE (FNP-C)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:LEE
Last Name:WELCH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 E ASHLEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-7260
Mailing Address - Country:US
Mailing Address - Phone:801-824-9393
Mailing Address - Fax:
Practice Address - Street 1:2750 E COTTONWOOD PKWY STE 540
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-7298
Practice Address - Country:US
Practice Address - Phone:801-278-9062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12379690-4405363L00000X
UT12379690-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner