Provider Demographics
NPI:1568727063
Name:WEISS, BETSY ANN (RN,MSN)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:ANN
Last Name:WEISS
Suffix:
Gender:F
Credentials:RN,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1527
Mailing Address - Country:US
Mailing Address - Phone:847-564-0476
Mailing Address - Fax:
Practice Address - Street 1:310 OLD POST RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1527
Practice Address - Country:US
Practice Address - Phone:847-564-0476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.002275163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health