Individual
DR. KATIE JOY WEEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2007019154
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04580012
BLUE CROSS BLUE SHIELD 8 DIGIT BILLING NUMBER
—
01
—
39666014
BLUE CROSS BLUE SHIELD KC
—
Enumeration date
07/24/2007
Last updated
04/26/2010
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