Individual
TIFFANY WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2161 W SPRING ST, MONROE, GA 30655-3203
(770) 267-4470
Mailing address
2161 W SPRING ST, MONROE, GA 30655-3203
(770) 267-4470
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007679
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291681900
—
FL
01
—
547541
HEALTHEASE
FL
01
—
SG075554
VISTA (MCD)
DC
Enumeration date
02/13/2006
Last updated
03/28/2018
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