Provider Demographics
NPI:1245701556
Name:WESTON, TAMI MARIE (APRNCNP)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:MARIE
Last Name:WESTON
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:TAMMIE
Other - Middle Name:MARIE
Other - Last Name:WESTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:7911 E COUNTY ROAD 50 N
Mailing Address - Street 2:
Mailing Address - City:MOORES HILL
Mailing Address - State:IN
Mailing Address - Zip Code:47032-9612
Mailing Address - Country:US
Mailing Address - Phone:812-584-4817
Mailing Address - Fax:
Practice Address - Street 1:147 W GREEN MEADOWS DR STE 2
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-4000
Practice Address - Country:US
Practice Address - Phone:812-200-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-13
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71010946A363LP0808X, 363LP0808X
OH023048363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health