Provider Demographics
NPI:1891956041
Name:WEISS, HANNAH GAILLARD (DNP)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:GAILLARD
Last Name:WEISS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 MONUMENT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-2520
Mailing Address - Country:US
Mailing Address - Phone:904-642-0337
Mailing Address - Fax:904-642-0928
Practice Address - Street 1:2401 MONUMENT RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-2520
Practice Address - Country:US
Practice Address - Phone:904-420-3376
Practice Address - Fax:904-420-9286
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA588492163W00000X, 363LF0000X
CA21197363LF0000X
FL9398113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIC290ZMedicare Oscar/Certification