1245701556 NPI number — TAMI MARIE WESTON APRN.CNP

Table of content: TAMI MARIE WESTON APRN.CNP (NPI 1245701556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245701556 NPI number — TAMI MARIE WESTON APRN.CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WESTON
Provider First Name:
TAMI
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN.CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WESTON
Provider Other First Name:
TAMMIE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN, CNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1245701556
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7911 E COUNTY ROAD 50 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOORES HILL
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47032-9612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-584-4817
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
147 W GREEN MEADOWS DR STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENFIELD
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46140-4000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-200-2789
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2018

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: 363LP0808X , with the licence number:  71010946A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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