Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | TRN28157 | FL |
NPI | 1043674864 |
---|---|
Provider Name | Lurah Elizabeth Welch |
First Address | Shreveport, LA 71103-4228 |
Second Address | Jacksonville, FL 32209-6511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2016 |
Last Update Date | 18/10/2019 |