Provider Demographics
NPI:1588720247
Name:WELSH, BARBARA (APRN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:WELSH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 TRUMAN WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2070
Mailing Address - Country:US
Mailing Address - Phone:860-257-1020
Mailing Address - Fax:860-257-4102
Practice Address - Street 1:30 TRUMAN WAY
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2070
Practice Address - Country:US
Practice Address - Phone:860-257-1020
Practice Address - Fax:860-257-4102
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4721363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP12885OtherUPIN
CT008034455Medicaid