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General NPI Number Information
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NPI Number | 1972853679
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Entity Type | Individual
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Provider Name | SUSAN WEISS
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Gender | Female
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 06/28/2020
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Provider Practice Location Address
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Address Line | 351 W CAMDEN ST
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City | BALTIMORE
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State | MD
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Zip | 21201-7912
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Country | US
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Telephone | 410-625-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 BREN ROAD EAST MAIL ROUTE MN 008-B213
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City | MINNETONKA
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State | MN
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Zip | 55343
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 119841
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 03937
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License Number State | OH
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