Provider Demographics
NPI:1972625788
Name:WELCH, LAURI A (NP)
Entity type:Individual
Prefix:
First Name:LAURI
Middle Name:A
Last Name:WELCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 RESEARCH PL
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2412
Mailing Address - Country:US
Mailing Address - Phone:978-459-6737
Mailing Address - Fax:978-459-2580
Practice Address - Street 1:20 RESEARCH PL
Practice Address - Street 2:SUITE 220
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2412
Practice Address - Country:US
Practice Address - Phone:978-459-6737
Practice Address - Fax:978-459-2580
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA186383363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0701921Medicaid
MANP1752OtherBCBS
MAS31663Medicare UPIN
MAWENP1752Medicare ID - Type Unspecified