Welthalyn Bogar
Individual provider Active NPI Nurse's Aide · Dallas, GA
NPI 1609643360 · NPPES record last updated Dec 4, 2023
Key facts
- NPI
- 1609643360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- CN0030089772 (GA)
- Practice address
- 110 Evans Mill Dr
Dallas, GA 30157-1622 - Phone
- (770) 435-2555
- NPI assigned
- Dec 4, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CN0030089772 | GA | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CN0030089772 | GA | Yes |
Addresses
Primary practice location
110 Evans Mill Dr
Dallas, GA 30157-1622
Mailing address
5755 Glenridge Dr Unit 129
Atlanta, GA 30328-5552
Phone (404) 576-3895
Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.