Provider Demographics
NPI:1013970573
Name:WEISS, ANNE M (FNP C)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:WEISS
Suffix:
Gender:F
Credentials:FNP C
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:BONZEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2896
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:190 CAMPUS BLVD STE 201
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2872
Practice Address - Country:US
Practice Address - Phone:540-536-5980
Practice Address - Fax:540-536-5979
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007788282Medicaid
WV7105032000Medicaid
500022500OtherRAILROAD MEDICARE
VA022066W18Medicare PIN
VA007788282Medicaid