Provider Demographics
NPI:1528128964
Name:WELSH, EILEEN PERKETT (FNP)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:PERKETT
Last Name:WELSH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W TRYON ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2438
Mailing Address - Country:US
Mailing Address - Phone:919-245-2400
Mailing Address - Fax:919-644-3312
Practice Address - Street 1:2501 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-9087
Practice Address - Country:US
Practice Address - Phone:919-968-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPENDINGMedicaid