Provider Demographics
NPI:1316091408
Name:WEBER, JANET RAYE (FAMILY NURSE PRACTIT)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:RAYE
Last Name:WEBER
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
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Mailing Address - Street 1:6365 E TANQUE VERDE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3830
Mailing Address - Country:US
Mailing Address - Phone:520-290-0300
Mailing Address - Fax:
Practice Address - Street 1:6365 E TANQUE VERDE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3830
Practice Address - Country:US
Practice Address - Phone:520-290-0300
Practice Address - Fax:520-290-5674
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZNP804363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00600277OtherRR MEDICARE
AZP00600277OtherRR MEDICARE