Provider Demographics
NPI:1306188560
Name:WEISS, JESSICA LANE (RN, WHNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LANE
Last Name:WEISS
Suffix:
Gender:F
Credentials:RN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:80 MAIDEN LN
Mailing Address - Street 2:STE 901
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4811
Mailing Address - Country:US
Mailing Address - Phone:212-366-4765
Mailing Address - Fax:212-229-1020
Practice Address - Street 1:80 MAIDEN LN
Practice Address - Street 2:STE 901
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4811
Practice Address - Country:US
Practice Address - Phone:212-366-4765
Practice Address - Fax:212-229-1020
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY657412-1163W00000X
NY421153-1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse