Provider Demographics
NPI:1699342915
Name:WEEKLEY, JENNA D (APRN)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:D
Last Name:WEEKLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:D
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:KS
Mailing Address - Zip Code:66414-9607
Mailing Address - Country:US
Mailing Address - Phone:785-836-7111
Mailing Address - Fax:
Practice Address - Street 1:211 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:KS
Practice Address - Zip Code:66414-9607
Practice Address - Country:US
Practice Address - Phone:785-836-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-06
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-79905363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner