Healthcare Provider Details

I. General information

NPI: 1952958860
Provider Name (Legal Business Name): DEBORAH KAY WEESE APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 DARROW RD STE 106
HUDSON OH
44236-5026
US

IV. Provider business mailing address

12253 COLUMBIANA CANFIELD RD
COLUMBIANA OH
44408-9776
US

V. Phone/Fax

Practice location:
  • Phone: 330-656-5911
  • Fax:
Mailing address:
  • Phone: 330-921-9542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.024827
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: