Provider Demographics
NPI:1992492144
Name:WEISS, CHERISE (RN, IFNCP)
Entity type:Individual
Prefix:MRS
First Name:CHERISE
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:RN, IFNCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9726 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-9179
Mailing Address - Country:US
Mailing Address - Phone:715-497-9757
Mailing Address - Fax:
Practice Address - Street 1:9726 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-9179
Practice Address - Country:US
Practice Address - Phone:715-497-9757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI175103-30163W00000X
133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No133N00000XDietary & Nutritional Service ProvidersNutritionist