Individual
JESSICA DAWN WEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
333 LAIDLEY ST, CHARLESTON, WV 25301-1614
(304) 344-0096
Mailing address
110 ROANE ST, CHARLESTON, WV 25302-2334
(304) 344-0096
(304) 342-4725
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
64654
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
082504
WV
Other
Enumeration date
08/18/2009
Last updated
05/22/2013
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