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General NPI Number Information
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NPI Number | 1396177671
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Entity Type | Individual
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Provider Name | ABBIE LEE WEATHERLEY APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 05/17/2018
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Provider Practice Location Address
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Address Line | 201 NW R D MIZE RD
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City | BLUE SPRINGS
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State | MO
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Zip | 64014
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Country | US
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Telephone | 816-655-5472
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 505411
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City | SAINT LOUIS
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State | MO
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Zip | 63150-5411
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-76003-011
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License Number State | KS
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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 | 2014036571
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License Number State | MO
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