Provider Demographics
NPI:1407355886
Name:WEITZEL, LINDA K (RN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:K
Last Name:WEITZEL
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 1:210 W 39TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-3740
Mailing Address - Country:US
Mailing Address - Phone:402-494-2425
Mailing Address - Fax:402-494-3916
Practice Address - Street 1:210 W 39TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3740
Practice Address - Country:US
Practice Address - Phone:402-494-2425
Practice Address - Fax:402-494-3916
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA089732163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool