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General NPI Number Information
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NPI Number | 1740816933
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Entity Type | Individual
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Provider Name | DIANE S WEIS FNP
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Gender | Female
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 265 BROOKVIEW CENTRE WAY STE 400
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City | KNOXVILLE
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State | TN
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Zip | 37919-4052
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Country | US
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Telephone | 865-693-1000
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Fax | 865-539-8052
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Provider Business Mailing Address
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Address Line | 1601 PAR CT
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City | JOHNSON CITY
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State | TN
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Zip | 37601-2666
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Country | US
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Telephone | 423-833-4808
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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 | F02200330
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License Number State | TN
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