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Individual

JON TODD WEAKLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
311 MORROW ST N, MENA, AR 71953-2516
(479) 243-2333
(479) 394-4577
Mailing address
311 MORROW ST N, MENA, AR 71953-2516
(479) 243-2333
(479) 394-4577

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
C01447
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
200860009CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
APRN.CRNA.0020179
OH

Other

Enumeration date
06/08/2006
Last updated
03/18/2021
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