Provider Demographics
NPI:1982860599
Name:WEEMS, STEPHANIE (MSN/FNP/ EDD)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:WEEMS
Suffix:
Gender:F
Credentials:MSN/FNP/ EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PHYSICIANS DR STE B
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2100
Mailing Address - Country:US
Mailing Address - Phone:256-839-9797
Mailing Address - Fax:601-825-8130
Practice Address - Street 1:102 PHYSICIANS DR STE B
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2100
Practice Address - Country:US
Practice Address - Phone:256-389-9797
Practice Address - Fax:601-825-8130
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-03
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-103953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL152057Medicaid