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General NPI Number Information
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NPI Number | 1215378203
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Entity Type | Individual
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Provider Name | ALANA MICHELLE WEATHERLY PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/08/2013
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 14540 OLD SAINT AUGUSTINE RD SUITE 2391
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City | JACKSONVILLE
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State | FL
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Zip | 32258-7418
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Country | US
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Telephone | 904-262-3372
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Fax | 904-262-3306
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Provider Business Mailing Address
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Address Line | PO BOX 860912
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City | MINNEAPOLIS
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State | MN
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Zip | 55486-0912
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9107347
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License Number State | FL
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