Basic Information
Provider Information
NPI: 1639165327
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEEKS
FirstName: STEPHANIE
MiddleName: BOYCE
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2369 STAPLES MILL RD
Address2: SUITE 200
City: RICHMOND
State: VA
PostalCode: 232302918
CountryCode: US
TelephoneNumber: 8042854465
FaxNumber: 8042858332
Practice Location
Address1: 5855 BREMO RD
Address2: SUITE 706
City: RICHMOND
State: VA
PostalCode: 232261926
CountryCode: US
TelephoneNumber: 8042858206
FaxNumber: 8042850162
Other Information
ProviderEnumerationDate: 09/27/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X0024155602VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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