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Individual

JENNIFER WEESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2001 VAIL AVE, ANESTHESIA SERVICES, CHARLOTTE, NC 28207-1219
(704) 304-6202
Mailing address
PO BOX 60499, ANESTHESIA, CHARLOTTE, NC 28260-0499
(704) 304-6202

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
51771
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8054244
NC
05
NAN412
SC
Enumeration date
06/12/2006
Last updated
11/08/2012
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