MEDICARE: MRS. CLAUDIA WEIR ANTHONY NP-C

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	363LF0000X	Family Nurse Practitioner	R864863	MS
2	163WR0006X	Registered Nurse First Assistant	R864863	MS
3	363LF0000X	Family Nurse Practitioner	F0715496	MS

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	:	1972530632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CLAUDIA WEIR ANTHONY NP-C

Provider Business Mailing Address
First Line	:	965 RIDGE LAKE BLVD STE 103
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-9446
Country	:	US
Telephone Number	:	901-227-3255
Fax Number	:	601-984-5733

Provider Business Practice Location Address
First Line	:	1887 SPILLWAY RD
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39047
Country	:	US
Telephone Number	:	601-992-5532
Fax Number	:	601-992-5547

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	01/31/2019

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