Provider Demographics
NPI:1528062262
Name:WEISER, JEANETTE MARLENE (ARNP-C)
Entity type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:MARLENE
Last Name:WEISER
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:MARLENE
Other - Last Name:HANCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-C
Mailing Address - Street 1:1208 LUTHER ST.
Mailing Address - Street 2:
Mailing Address - City:EADS
Mailing Address - State:CO
Mailing Address - Zip Code:81036-1180
Mailing Address - Country:US
Mailing Address - Phone:719-438-5401
Mailing Address - Fax:
Practice Address - Street 1:1208 LUTHER ST.
Practice Address - Street 2:
Practice Address - City:EADS
Practice Address - State:CO
Practice Address - Zip Code:81036-1180
Practice Address - Country:US
Practice Address - Phone:719-438-5401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002753363L00000X
KS45120363LC0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine