Weiss, Madonna

Weiss, Madonna is an individual health care provider with primary practice located at 1105 W Liberty St Suite 4050, Farmington MO 63640-1921. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Weiss, Madonna can be contacted via phone (573) 756-7844.

Contact Information

Primary practice address
1105 W Liberty St Suite 4050 Farmington MO 63640-1921
Phone: (573) 756-7844
Fax: (573) 756-9597
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 070291 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 070291 Missouri

Profile Details

NPI number 1780789206
LBN Legal business name Weiss, Madonna
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Oct 9th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780789206 NPPES
Missouri MEDICAID 425285707

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