Provider Demographics
NPI:1245573179
Name:WEILER, AMY CATHERINE (CPNP-PC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CATHERINE
Last Name:WEILER
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:CATHERINE
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2530 CHICAGO AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4291
Mailing Address - Country:US
Mailing Address - Phone:612-813-8800
Mailing Address - Fax:
Practice Address - Street 1:2530 CHICAGO AVE STE 500
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4291
Practice Address - Country:US
Practice Address - Phone:612-813-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20130393363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics