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General NPI Number Information
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NPI Number | 1124013362
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Entity Type | Individual
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Provider Name | D-ANN MARIE WELLER CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 2145 E BASELINE RD STE 104
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City | TEMPE
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State | AZ
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Zip | 85283-1546
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Country | US
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Telephone | 240-299-5308
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Fax |
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Provider Business Mailing Address
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Address Line | 10123 E ISLETA AVE
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City | MESA
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State | AZ
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Zip | 85209-7775
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Country | US
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Telephone | 240-299-5308
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3015070
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP30006785
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9371233
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP11586
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License Number State | AZ
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