Provider Demographics
NPI:1417211459
Name:WEEDMAN, ANN K (RN)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:K
Last Name:WEEDMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 PINE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-4933
Mailing Address - Country:US
Mailing Address - Phone:812-401-3689
Mailing Address - Fax:812-429-9655
Practice Address - Street 1:2700 W INDIANA ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5637
Practice Address - Country:US
Practice Address - Phone:812-428-0698
Practice Address - Fax:812-429-9655
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28089616A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse