Provider Demographics
NPI:1184015109
Name:WEBER, DOROTHEA LEONIS (LPN)
Entity Type:Individual
Prefix:
First Name:DOROTHEA
Middle Name:LEONIS
Last Name:WEBER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 EAST 10TH STREET
Mailing Address - Street 2:TUCSON UNIFIED SCHOOL DISTRICT
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719
Mailing Address - Country:US
Mailing Address - Phone:520-225-6645
Mailing Address - Fax:
Practice Address - Street 1:1010 EAST 10TH STREET
Practice Address - Street 2:TUCSON UNIFIED SCHOOL DISTRICT
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:520-225-6645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP045324164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse