| Doctor Name: | NICOLE ANN WEATHERS |
| NPI Number: | 1457793028 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 4704273785 |
| Business Practice Address: | 601 W Superior St Munising, MI - 498621328 |
| Business Phone Number: | 9062331322 |
| Business Fax Number: | 9062331220 |
| Mailing Address: | 601 W Superior St, MUNISING |
| State: | MI |
| Postal Code: | 498621328 |
| Phone Number: | 9062331322 |
| Fax Number: | 9062331220 |
| NPI Enumeration Date: | 07/24/2013 |
| NPI Last Update Date: | 07/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 4704273785 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |