Individual
MARY C WEIS-FOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP C
Contact information
Practice address
327 PARK AVE, FORT LUPTON, CO 80621-1929
(303) 857-2711
(303) 857-1408
Mailing address
327 N PARK AVE, FT LUPTON, CO 80621
(303) 857-2711
(303) 857-1408
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
77084
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012773590
—
CO
Enumeration date
09/19/2006
Last updated
03/07/2023
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