Provider Demographics
NPI:1952072142
Name:WEEKES, ELVIRA P (RN)
Entity Type:Individual
Prefix:
First Name:ELVIRA
Middle Name:P
Last Name:WEEKES
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 1:2595 CAPTAINS ROW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3062
Mailing Address - Country:US
Mailing Address - Phone:706-473-9336
Mailing Address - Fax:
Practice Address - Street 1:4305 PAXTON LN SW APT 809
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-8401
Practice Address - Country:US
Practice Address - Phone:404-441-2394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA138942163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator