Provider Demographics
NPI:1346137197
Name:WEISE, MARYBETH P
Entity type:Individual
Prefix:
First Name:MARYBETH
Middle Name:P
Last Name:WEISE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9012 Q ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3549
Mailing Address - Country:US
Mailing Address - Phone:402-315-1000
Mailing Address - Fax:
Practice Address - Street 1:1445 N BELL ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-3534
Practice Address - Country:US
Practice Address - Phone:402-619-0331
Practice Address - Fax:402-619-0331
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist