Provider Demographics
NPI:1669584157
Name:WEIDMAN, DEVIN MARIE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:DEVIN
Middle Name:MARIE
Last Name:WEIDMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 SE OCEAN BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3301
Mailing Address - Country:US
Mailing Address - Phone:772-283-8380
Mailing Address - Fax:772-283-5538
Practice Address - Street 1:2220 SE OCEAN BLVD STE 101
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3301
Practice Address - Country:US
Practice Address - Phone:772-283-8380
Practice Address - Fax:772-283-5538
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2622122363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE4433YMedicare ID - Type UnspecifiedMEDICARE GROUP #
FLP11594Medicare UPIN