1487918082 NPI number — MRS. MEGAN DAWN WEESE APRN

Table of content: MRS. MEGAN DAWN WEESE APRN (NPI 1487918082)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487918082 NPI number — MRS. MEGAN DAWN WEESE APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEESE
Provider First Name:
MEGAN
Provider Middle Name:
DAWN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487918082
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70 N STURMER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26250-7403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-823-2800
Provider Business Mailing Address Fax Number:
304-823-2703

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ABU WELLNESS CENTER
Provider Second Line Business Practice Location Address:
101 COLLEGE HILL DRIVE
Provider Business Practice Location Address City Name:
PHILIPPI
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-457-0400
Provider Business Practice Location Address Fax Number:
304-457-0402
Provider Enumeration Date:
06/27/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  77306 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)