Provider Demographics
NPI:1144843467
Name:WELNIAK, ALISHA DANIELLE (DNP)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:DANIELLE
Last Name:WELNIAK
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4621 N 166TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2907
Mailing Address - Country:US
Mailing Address - Phone:308-730-2147
Mailing Address - Fax:
Practice Address - Street 1:13939 GOLD CIR STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2316
Practice Address - Country:US
Practice Address - Phone:402-881-3638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112916363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health