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NPI Code Detail

MEDICARE: MRS. IVEY NOELLE WEIMER

MEDICARE: MRS. IVEY NOELLE WEIMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1023956471
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. IVEY NOELLE WEIMER
Provider Business Mailing Address
First Line : 525 VINE ST STE 530
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27101-4155
Country : US
Telephone Number : 336-716-4356
Fax Number :
Provider Business Practice Location Address
First Line : 225 BALDWIN AVE
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-3109
Country : US
Telephone Number : 704-376-1605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 06/03/2026

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Directions to “ MRS. IVEY NOELLE WEIMER ” Practice Location

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