Healthcare Provider Details

I. General information

NPI: 1013970573
Provider Name (Legal Business Name): ANNE M WEISS FNP C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE M BONZEK

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 CAMPUS BLVD STE 201
WINCHESTER VA
22601-2872
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 100
WINCHESTER VA
22601-2896
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-5980
  • Fax: 540-536-5979
Mailing address:
  • Phone: 540-536-5100
  • Fax: 540-536-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0101231825
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: