Petrona Ennis-Welch, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F338601-1 Issued in NY

Practice address

414 McClellan Ave PH
Mount Vernon, NY 10553-2103

Phone

(914) 665-8045

NPI assigned

Jun 7, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1427438266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 MCCLELLAN AVE PH",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105532103",
            "telephone_number": "914-665-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 MCCLELLAN AVE PH",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105532103",
            "telephone_number": "914-665-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS-WELCH",
        "first_name": "PETRONA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-07",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F338601-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338601-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeesha Elliott
• Crystal Ellis, LPN
• Donna Rosemarie Ellis, RN
• Steven Gioe Emerson, LCSW
• Encouraged Wellness
• Jeannelle A Ernest-Hill, RN
• Alba I Escobar
• Michelle Espinal
• Christian Esposito
• Fabiola Estera

• Family Nurse Practitioner in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.