Individual
DR. JOHN JOSEPH WEATHERWAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7525
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7525
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0017141525
VA
163W00000X
Registered Nurse
0024171604
VA
163W00000X
Registered Nurse
ARNP 2749302
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP2749302
FL
Other
Enumeration date
09/01/2005
Last updated
04/16/2018
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