Provider Demographics
NPI:1548491087
Name:WELCH, ANN MARIE
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:WELCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:HAFFELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9640 N. COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53190
Mailing Address - Country:US
Mailing Address - Phone:608-921-9513
Mailing Address - Fax:
Practice Address - Street 1:9640 N. COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:WHITEWATER
Practice Address - State:WI
Practice Address - Zip Code:53190
Practice Address - Country:US
Practice Address - Phone:608-921-9513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI134246-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse