Provider Demographics
NPI:1386414787
Name:WEEGMANN, DIANA ANGELICA (APRN)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:ANGELICA
Last Name:WEEGMANN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746654
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6654
Mailing Address - Country:US
Mailing Address - Phone:904-202-2092
Mailing Address - Fax:904-393-7603
Practice Address - Street 1:1301 PALM AVE STE 600
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8432
Practice Address - Country:US
Practice Address - Phone:904-202-7300
Practice Address - Fax:904-202-7433
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11030222363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner