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General NPI Number Information
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NPI Number | 1891283453
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Entity Type | Individual
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Provider Name | MARIA ELIZABETH WESTON AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/28/2018
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 3535 W 13 MILE RD STE 248
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City | ROYAL OAK
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State | MI
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Zip | 48073-6770
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Country | US
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Telephone | 248-551-1515
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Fax | 248-551-1516
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Provider Business Mailing Address
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Address Line | 2558 LITCHFIELD DR
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City | WATERFORD TOWNSHIP
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State | MI
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Zip | 48329-3959
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Country | US
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Telephone | 248-296-3765
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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 | 4704303808
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License Number State | MI
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