Provider Demographics
NPI:1124149331
Name:WELLER, JEAN LORRAINE (RN)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:LORRAINE
Last Name:WELLER
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:KRUG
Other - Last Name:WELLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:125 MILLERS CROSSING ROAD
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961
Mailing Address - Country:US
Mailing Address - Phone:570-943-2061
Mailing Address - Fax:
Practice Address - Street 1:OLD RT 22
Practice Address - Street 2:HAMBURG CENTER
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526
Practice Address - Country:US
Practice Address - Phone:610-562-6006
Practice Address - Fax:610-562-6085
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN333570L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse