Provider Demographics
NPI:1841178621
Name:WELCH, SHAWNTELL
Entity type:Individual
Prefix:
First Name:SHAWNTELL
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11623 ROSS COMMON DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-5248
Mailing Address - Country:US
Mailing Address - Phone:317-429-7095
Mailing Address - Fax:
Practice Address - Street 1:11623 ROSS COMMON DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-5248
Practice Address - Country:US
Practice Address - Phone:317-429-7095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health