Provider Demographics
NPI:1205229226
Name:FAYE WEISS, RN,CNS,PC
Entity type:Organization
Organization Name:FAYE WEISS, RN,CNS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, CNS,PC
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CNS, PC
Authorized Official - Phone:701-833-8158
Mailing Address - Street 1:129 18TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-3406
Mailing Address - Country:US
Mailing Address - Phone:701-839-1312
Mailing Address - Fax:701-839-0986
Practice Address - Street 1:129 18TH ST. SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701
Practice Address - Country:US
Practice Address - Phone:701-839-1312
Practice Address - Fax:701-839-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR26679261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health