MEDICARE: MS. MARY BETH WEIMER CNM

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
1	176B00000X	Midwife	ARNP9406331	FL
2	176B00000X	Midwife	25ME00022201	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508909920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY BETH WEIMER CNM

Provider Business Mailing Address
First Line	:	PO BOX 1357
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-1357
Country	:	US
Telephone Number	:	239-278-3600
Fax Number	:	239-226-4650

Provider Business Practice Location Address
First Line	:	13195 METRO PKWY
Second Line	:	#6-9
City	:	FORT MYERS
State	:	FL
Zip	:	33966-4810
Country	:	US
Telephone Number	:	239-344-2348
Fax Number	:	239-479-5194

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	05/05/2017

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