Healthcare Provider Details

I. General information

NPI: 1952264251
Provider Name (Legal Business Name): MEGHAN ELIZABETH WEAKLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HOSPITAL DR
UTICA NY
13502-2517
US

IV. Provider business mailing address

8654 PARKER HOLLOW RD
BARNEVELD NY
13304-2324
US

V. Phone/Fax

Practice location:
  • Phone: 315-917-9966
  • Fax:
Mailing address:
  • Phone: 315-360-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number759916
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: