Provider Demographics
NPI:1730107434
Name:WEISS, ANNA (RN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 S GALENA ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5079
Mailing Address - Country:US
Mailing Address - Phone:303-752-9494
Mailing Address - Fax:303-752-9797
Practice Address - Street 1:3443 S GALENA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5079
Practice Address - Country:US
Practice Address - Phone:303-752-9494
Practice Address - Fax:303-752-9797
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO067434251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60338521Medicaid
CO067434Medicare PIN