Provider Demographics
NPI:1619398245
Name:WEATHERSPOON, VERONICA (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:WEATHERSPOON
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 S MASON RD # 437
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1706 S 68TH ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-4949
Practice Address - Country:US
Practice Address - Phone:414-674-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023001837363LP0808X
TXAP124919363LF0000X
RIAPRN01995363LP0808X
WI13515-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily