Provider Demographics
NPI:1871180570
Name:WESTON, KATHY LYNN (RN)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:LYNN
Last Name:WESTON
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 1:1009 LEE LN
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-8103
Mailing Address - Country:US
Mailing Address - Phone:615-806-2426
Mailing Address - Fax:
Practice Address - Street 1:3025 FERNBROOK LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-1623
Practice Address - Country:US
Practice Address - Phone:615-806-2426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN58700163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse