Provider Demographics
NPI:1104304856
Name:WELTHA, STEPHANIE CELESTE (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:CELESTE
Last Name:WELTHA
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 S JONES BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2283
Mailing Address - Country:US
Mailing Address - Phone:702-880-4193
Mailing Address - Fax:
Practice Address - Street 1:3835 S JONES BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2283
Practice Address - Country:US
Practice Address - Phone:702-880-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV811230363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner