Healthcare Provider Details

I. General information

NPI: 1952911059
Provider Name (Legal Business Name): TRISHA BETH WEYMERS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2020
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 WOLF PARK DR
GERMANTOWN TN
38138-1759
US

IV. Provider business mailing address

1325 WOLF PARK DR STE 103
GERMANTOWN TN
38138-1759
US

V. Phone/Fax

Practice location:
  • Phone: 901-252-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number904300
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number28220
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0000162283
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: