Provider Demographics
NPI:1407046162
Name:WEEKLEY, LAURA (RN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:WEEKLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3349 WATERWORKS RD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:GA
Mailing Address - Zip Code:30529-5142
Mailing Address - Country:US
Mailing Address - Phone:706-983-0938
Mailing Address - Fax:706-335-3912
Practice Address - Street 1:3349 WATERWORKS RD
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:GA
Practice Address - Zip Code:30529-5149
Practice Address - Country:US
Practice Address - Phone:706-983-0938
Practice Address - Fax:706-335-3912
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN160263163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse