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NPI Code Detail

MEDICARE: AMANDA JEAN WEIR NP

MEDICARE: AMANDA JEAN WEIR NP
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
1363LF0000XFamily Nurse Practitioner642431CA

General Provider Information

NPI Number : 1871730747
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JEAN WEIR NP
Provider Business Mailing Address
First Line : 2342 PROFESSIONAL PKWY STE 310
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-6819
Country : US
Telephone Number : 805-934-2488
Fax Number :
Provider Business Practice Location Address
First Line : 2342 PROFESSIONAL PKWY STE 310
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-6819
Country : US
Telephone Number : 805-934-2488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2009
Last Update Date : 08/12/2022

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