Provider Demographics
NPI:1669902755
Name:THE WEEKEND CLINIC PLC
Entity type:Organization
Organization Name:THE WEEKEND CLINIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENMOUSSA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:563-362-3312
Mailing Address - Street 1:2107 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-3706
Mailing Address - Country:US
Mailing Address - Phone:563-362-3312
Mailing Address - Fax:563-726-7369
Practice Address - Street 1:2107 E 12TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-3706
Practice Address - Country:US
Practice Address - Phone:563-362-3312
Practice Address - Fax:563-726-7369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA139678363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty