Mandy K Weitsz, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R232185 Issued in MD

Practice address

191 Mahogany Dr
North East, MD 21901-3650

Phone

(443) 652-0940

NPI assigned

Oct 28, 2022

Last updated

May 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1922715093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 MAHOGANY DR",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013650",
            "telephone_number": "443-652-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 MAHOGANY DR",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013650",
            "telephone_number": "443-652-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITSZ",
        "first_name": "MANDY",
        "middle_name": "K",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R232185",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R232185",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-5450)
• Wal-Mart Stores East, LP (Vision Center 30-5450)
• Walgreen Co
• Walgreen Co. (Walgreens #11037)
• Destinee Renee Webster, LMSW
• Carolyn Marie Wells, LCPC
• Elizabeth Grace Wolf, LCSW

• Family Nurse Practitioner in North East, MD
• Providers in North East, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.