Provider Demographics
NPI:1174872246
Name:WELWOLIE, MCARTHUR N (LPN)
Entity type:Individual
Prefix:
First Name:MCARTHUR
Middle Name:N
Last Name:WELWOLIE
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 OAKWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-7613
Mailing Address - Country:US
Mailing Address - Phone:216-372-0014
Mailing Address - Fax:
Practice Address - Street 1:1390 OAKWOOD TRL
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-7613
Practice Address - Country:US
Practice Address - Phone:216-372-0014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH148102164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse