Provider Demographics
NPI:1689995961
Name:WEYLAND, BETTY JEAN (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:JEAN
Last Name:WEYLAND
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N3882 MCHUGH RD
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:WI
Mailing Address - Zip Code:54130-7541
Mailing Address - Country:US
Mailing Address - Phone:920-366-8943
Mailing Address - Fax:920-687-8827
Practice Address - Street 1:N3882 MCHUGH RD
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:WI
Practice Address - Zip Code:54130-7541
Practice Address - Country:US
Practice Address - Phone:920-366-8943
Practice Address - Fax:920-687-8827
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI162295-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse