Provider Demographics
NPI:1548034697
Name:WEEKLEY, JESSICA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:WEEKLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21200 CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:GUYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45735-9557
Mailing Address - Country:US
Mailing Address - Phone:304-514-4088
Mailing Address - Fax:
Practice Address - Street 1:21200 CHAPMAN RD
Practice Address - Street 2:
Practice Address - City:GUYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45735-9557
Practice Address - Country:US
Practice Address - Phone:304-514-4088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant