MEDICARE: JAYMEE WEITZMAN CRNP

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	363L00000X	Nurse Practitioner	SP017725	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SP017725	OTHER	PA	NURSE PRACTITIONER LICENSE

General Provider Information

NPI Number	:	1609399203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYMEE WEITZMAN CRNP

Provider Business Mailing Address
First Line	:	5730 EXECUTIVE DR STE 230
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-1762
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	907 ADAM CT
Second Line	:
City	:	NEW HOPE
State	:	PA
Zip	:	18938-9550
Country	:	US
Telephone Number	:	215-266-3522
Fax Number	:	215-770-9463

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

Provider Enumeration Date	:	07/25/2017
Last Update Date	:	03/11/2026

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