Provider Demographics
NPI:1437158219
Name:WEIDEMANN, WINONA DARLENE (RN FNP)
Entity Type:Individual
Prefix:MRS
First Name:WINONA
Middle Name:DARLENE
Last Name:WEIDEMANN
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:NONI
Other - Middle Name:
Other - Last Name:WEIDEMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18550 DE PAUL DR
Mailing Address - Street 2:STE 208
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2911
Mailing Address - Country:US
Mailing Address - Phone:408-776-8040
Mailing Address - Fax:708-776-9089
Practice Address - Street 1:18550 DE PAUL DR
Practice Address - Street 2:STE 208
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2911
Practice Address - Country:US
Practice Address - Phone:408-776-8040
Practice Address - Fax:708-776-9089
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA216122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP24650Medicare UPIN