Provider Demographics
NPI:1609310275
Name:WEATHERS, ANDREA CAMPBELL
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:CAMPBELL
Last Name:WEATHERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SCOTTINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7568
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:WAKEMED CHILDREN'S PM URGENT CARE
Practice Address - Street 2:8841 SIX FORKS ROAD, SUITE 102
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615
Practice Address - Country:US
Practice Address - Phone:984-217-5437
Practice Address - Fax:984-205-1626
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39709208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics