Provider Demographics
NPI:1881247674
Name:WEISS, SALLY ANN (APRN, FNP-C, CNE)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:ANN
Last Name:WEISS
Suffix:
Gender:F
Credentials:APRN, FNP-C, CNE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4741 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2236
Mailing Address - Country:US
Mailing Address - Phone:954-242-0802
Mailing Address - Fax:
Practice Address - Street 1:4741 N 37TH ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2236
Practice Address - Country:US
Practice Address - Phone:954-242-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001403363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily