Healthcare Provider Details

I. General information

NPI: 1114722071
Provider Name (Legal Business Name): HELENE ELIZABETH WEIG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10503 SAN JOSE BLVD
JACKSONVILLE FL
32257-6295
US

IV. Provider business mailing address

10503 SAN JOSE BLVD
JACKSONVILLE FL
32257-6295
US

V. Phone/Fax

Practice location:
  • Phone: 904-450-6670
  • Fax: 904-450-6699
Mailing address:
  • Phone: 904-450-6670
  • Fax: 904-450-6699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11041561
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: