Individual
AMANDA WELCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1255 E COUNTY LINE RD APT K8, JACKSON, MS 39211-1830
(662) 402-9162
Mailing address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
902688
MS
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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