Provider Demographics
NPI:1366064719
Name:WELDEN, EULALIE DRAPER GIVEN (PA-C)
Entity type:Individual
Prefix:
First Name:EULALIE
Middle Name:DRAPER GIVEN
Last Name:WELDEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EULALIE
Other - Middle Name:CROMMELIN DRAPER
Other - Last Name:GIVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:2900 CAHABA RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-1937
Practice Address - Country:US
Practice Address - Phone:205-877-9773
Practice Address - Fax:205-877-9775
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.1590363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPA.1590OtherPA LICENSE