Provider Demographics
NPI:1962690354
Name:WEIRENS, NANCY KAY SHEELY (LAC, MS)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:KAY SHEELY
Last Name:WEIRENS
Suffix:
Gender:F
Credentials:LAC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6416 OAKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2031
Mailing Address - Country:US
Mailing Address - Phone:651-270-2902
Mailing Address - Fax:
Practice Address - Street 1:4422 WHITE BEAR AVE N
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-3475
Practice Address - Country:US
Practice Address - Phone:651-336-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1407171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist