MRS. MALLORY ANNE WEATHERLY (NPI# 1518521251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518521251 |
| Entity Type | Individual |
| Full Name | MRS. MALLORY ANNE WEATHERLY |
| Other Name | MALLORY ANNE WEIR |
| Credential | APRN |
| Practice Address |
3450 11th Court Suite 206 Vero Beach FL 32960 |
| Mailing Address |
325 14th Ave Vero Beach FL 32962-2719 |
| Practice Telephone | 7722993511 |
| Mailing Telephone | 7723213160 |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2019-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN11002191 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 00000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 36th St, Vero Beach, FL 329604862 | 7725674311 |
| Street Address |
3450 11TH COURT SUITE 206 |
| City | VERO BEACH |
| State | FL |
| Zip Code | 32960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851359731 | Bruce Mark Grossman | Internal Medicine | 3450 11th Court, Suite 206, Vero Beach, FL 32960-5012 | 2006-05-02 |
| 1205370327 | Indian River Health Services Inc | Internal Medicine | 3450 11th Court, Suite 104b, Vero Beach, FL 32960-4862 | 2016-12-08 |
| 1104378363 | Indian River Health Services Inc | Psychiatry & Neurology | 3450 11th Court, Suite 301b, Vero Beach, FL 32960-4862 | 2016-11-03 |
| 1275975237 | Jesse Lee Mace | Nurse Practitioner | 3450 11th Court, Suite 104, Vero Beach, FL 32960 | 2013-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891208872 | Fresenius Medical Care Vero Beach, LLC | Clinic/Center | 1515 Indian River Blvd Ste A101, Vero Beach, FL 32960 | 2017-11-13 |
| 1972016103 | Rer Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 2436 Us 1, Vero Beach, FL 32960 | 2017-11-09 |
| 1225558141 | Robby John Caballes | Podiatrist | 3735 11th Circle Ste 201, Vero Beach, FL 32960 | 2017-06-21 |
| 1407388978 | Haley Elizabeth Stewart | Counselor | 1925 20th Street, Vero Beach, FL 32960 | 2017-04-03 |
| 1861932949 | Daniel Martin | Specialist/Technologist | 4025 20th Street, Vero Beach, FL 32960 | 2017-03-08 |
| 1770957367 | Gail Jaffe Satuloff | Counselor | Terry Mindfulness Center, 333 17th St., Suite 2t, Vero Beach, FL 32960 | 2015-11-19 |
| 1104213172 | Kimberly Ann Aikey | Massage Therapist | 1715 37th Place #3, Vero Beach, FL 32960 | 2015-04-17 |
| 1992128482 | Jean Luc Franck | Internal Medicine | 920 37th Pl Ste 105, Vero Beach, FL 32960 | 2014-02-04 |
| 1417386624 | Ocean Addiction Recovery Services, LLC | Anesthesiology | 1705 19 Pl, Ste E-2, Vero Beach, FL 32960 | 2013-11-07 |
| 1609203835 | Cynthia S. Crawford, M.d. Pa | Physical Medicine & Rehabilitation | 1986 35th Avenue, Vero Beach, FL 32960 | 2013-10-02 |
| Find all providers in zip 32960 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477166627 | Nicole Guettler | Nurse Practitioner | 722 Broadway St, Vero Beach, FL 32960-5118 | 2020-08-27 |
| 1124659594 | Kimberly G Anderson | Nurse Practitioner | 4089 42nd Sq, Vero Beach, FL 32967-1963 | 2020-02-03 |
| 1760042972 | Megan Dean | Nurse Practitioner | 305 8th Ter, Vero Beach, FL 32962-2813 | 2019-06-19 |
| 1972001865 | Allison E Mills | Nurse Practitioner | 2546 Fairway Dr, Vero Beach, FL 32960-5005 | 2018-01-25 |
| 1124493432 | Macresia Ann Braziel | Nurse Practitioner | 3450 11th Ct Ste 305a, Vero Beach, FL 32960-5012 | 2015-12-11 |
| 1306214671 | Krista Mazzarella | Nurse Practitioner | 4141 Abington Woods Cir, Vero Beach, FL 32967-8812 | 2015-09-03 |
| 1952787392 | Sharon Webb Mezzina | Nurse Practitioner | 525 38th Ave, Vero Beach, FL 32968-1928 | 2015-08-08 |
| 1245632140 | Elizabeth Sofranko Adams | Nurse Practitioner | 7275 49th St, Vero Beach, FL 32967-5824 | 2014-09-23 |
| 1013325448 | George Estol Wadsworth | Nurse Practitioner | 275 18th St Ste 102, Vero Beach, FL 32960-0824 | 2014-07-29 |
| 1356756894 | Gerri Kroop | Nurse Practitioner | 1243 Tan Oak Pl, Vero Beach, FL 32966-4737 | 2014-06-24 |
| Find all providers in VERO BEACH | ||||
| City | VERO BEACH |
| Zip Code | 32960 |
Please comment or provide details below to improve the information on MRS. MALLORY ANNE WEATHERLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.