Provider Demographics
NPI:1447270087
Name:WIERMAN, ANN MAURA (MD, FACP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MAURA
Last Name:WIERMAN
Suffix:
Gender:F
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 N TENAYA WAY
Mailing Address - Street 2:STE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0444
Mailing Address - Country:US
Mailing Address - Phone:702-822-2000
Mailing Address - Fax:702-938-2237
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:STE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0444
Practice Address - Country:US
Practice Address - Phone:702-822-2000
Practice Address - Fax:702-938-2237
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9280207RH0003X
AZ25112207RH0003X
NV7788207RH0003X
CO32878207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019840Medicaid
NVG30004Medicare UPIN
NV83WCHKWM06Medicare ID - Type Unspecified