Provider Demographics
NPI:1518556349
Name:WEATHERS, SIERRA (NP-C)
Entity Type:Individual
Prefix:MS
First Name:SIERRA
Middle Name:
Last Name:WEATHERS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11776 ANISE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-7869
Mailing Address - Country:US
Mailing Address - Phone:815-756-0926
Mailing Address - Fax:
Practice Address - Street 1:11776 ANISE DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-7869
Practice Address - Country:US
Practice Address - Phone:815-756-0926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILF03200620363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily