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Alyssa Nicole Weiseman

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

7964 W Jefferson Blvd, Fort Wayne, IN 46804-4140

PECOS Enrollment

This provider is enrolled in PECOS as ALYSSA WEISEMAN.

Based on the most recent information from CMS, provider Alyssa Nicole Weiseman is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1629761986
Provider Type
Individual
Full Name
Weiseman, Alyssa Nicole
Title
Mrs.
Credential
NP, RD

Gender
Female
Sole Proprietor
No
Enumeration Date
6/1/2023
Last Updated
6/1/2023

Contact Information

Practice Location

7964 W Jefferson Blvd, Fort Wayne, IN 46804-4140

(260) 436-5670

(260) 436-4706

Mailing Location

7964 W Jefferson Blvd, Fort Wayne, IN 46804-4140

(260) 436-5670

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2023005980 Indiana

Alyssa Nicole Weiseman

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Berg, Jill C.

Payton, Angela M.

Pleshkan, Viktoriya Y.

Yarnall, Gina

Rp Care Llc

Evans-Seibert, Andrea J.

Hoover, Kara Rae

Fountain, Pamela Kinder

Fraze, Julie

Becktell, Leia A.