Individual
MRS. MEGAN REBECCA WEIDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-4048
(781) 744-8000
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8085
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
892400
MS
363L00000X
Nurse Practitioner
RN2300402
MA
363LF0000X
Family Nurse Practitioner
215704
LA
363LF0000X
Family Nurse Practitioner
903986
MS
363LF0000X
Family Nurse Practitioner
Primary
RN2300402
MA
Other
Enumeration date
08/17/2020
Last updated
02/19/2025
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