Healthcare Provider Details

I. General information

NPI: 1114466208
Provider Name (Legal Business Name): SHEILA WEESE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 2ND ST
SAINT MARYS WV
26170-1003
US

IV. Provider business mailing address

2910 EMERSON AVE
PARKERSBURG WV
26104-2519
US

V. Phone/Fax

Practice location:
  • Phone: 681-612-3501
  • Fax: 681-612-3504
Mailing address:
  • Phone: 304-428-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN74631NP
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: