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Individual

MR. BRETT L WELDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1333 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2046
(417) 967-3311
(417) 967-1234
Mailing address
1333 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2046
(417) 967-1265
(417) 967-1234

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2015014592
MO
363LF0000X
Family Nurse Practitioner
671959
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
2015014593
MO
367500000X
Certified Registered Nurse Anesthetist
671959
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26D0446923
CLIA
MO
05
910026517
MO
Enumeration date
12/20/2006
Last updated
05/06/2020
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