Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | TP000773D | PA |
NPI | 1023238722 |
---|---|
Provider Name | Victoria A. Weill |
First Address | North Wales, PA 19454-2658 |
Second Address | Lansdale, PA 19446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |