Individual
RENEE L WEATHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2477
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28147902A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009483A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300032526
—
IN
Enumeration date
08/23/2019
Last updated
07/29/2024
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