Provider Demographics
NPI:1124013362
Name:ROSS, D-ANN WELLER (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:D-ANN
Middle Name:WELLER
Last Name:ROSS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:D-ANN
Other - Middle Name:WELLER
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 11404
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4005
Mailing Address - Country:US
Mailing Address - Phone:941-766-4681
Mailing Address - Fax:
Practice Address - Street 1:713 E MARION AVE STE 121
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3862
Practice Address - Country:US
Practice Address - Phone:941-833-1760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9371233363LF0000X
KY3015070363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAQ24260Medicare UPIN