Provider Demographics
NPI:1487694030
Name:WEED, ANDREA K (DO)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:K
Last Name:WEED
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 N NEVADA ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3933
Mailing Address - Country:US
Mailing Address - Phone:775-841-2100
Mailing Address - Fax:775-841-7239
Practice Address - Street 1:812 NORTH NEVADA STREET
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3919
Practice Address - Country:US
Practice Address - Phone:775-841-2100
Practice Address - Fax:775-841-7239
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVF77677Medicare UPIN