Healthcare Provider Details

I. General information

NPI: 1548987563
Provider Name (Legal Business Name): BRETT WEIR DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 ILLINOIS AVE
FORT LEONARD WOOD MO
65473
US

IV. Provider business mailing address

GENERAL LEONARD WOOD COMMUNITY HOSPITAL 4234 ILLINOIS AVE
FORT LEONARD WOOD MO
65473-9098
US

V. Phone/Fax

Practice location:
  • Phone: 785-231-7479
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberAP144618
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: