Provider Demographics
NPI:1366113979
Name:WELCH, LORI A (ARNP, FRNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:A
Last Name:WELCH
Suffix:
Gender:F
Credentials:ARNP, FRNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-237-3985
Mailing Address - Fax:515-237-3994
Practice Address - Street 1:4003 NW URBANDALE DR
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7914
Practice Address - Country:US
Practice Address - Phone:515-237-3985
Practice Address - Fax:515-237-3994
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA165769363LF0000X
IAG181731363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily