Provider Demographics
NPI:1215080551
Name:WEISS, LOU ANN HALL (RN)
Entity type:Individual
Prefix:
First Name:LOU ANN
Middle Name:HALL
Last Name:WEISS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:2306 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0361
Mailing Address - Country:US
Mailing Address - Phone:916-973-9565
Mailing Address - Fax:
Practice Address - Street 1:3700 BUSINESS DR # 130
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-2164
Practice Address - Country:US
Practice Address - Phone:916-734-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA377966163WC0400X, 163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC0400XNursing Service ProvidersRegistered NurseCase Management
Not Answered163WG0600XNursing Service ProvidersRegistered NurseGerontology