Provider Demographics
NPI:1154427185
Name:WEISBERGER, CAROLINE M (APRN, BC)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:M
Last Name:WEISBERGER
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 ALBANY RD
Mailing Address - Street 2:
Mailing Address - City:WEST STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01266-9236
Mailing Address - Country:US
Mailing Address - Phone:413-496-0701
Mailing Address - Fax:413-232-6136
Practice Address - Street 1:43 ALBANY RD
Practice Address - Street 2:
Practice Address - City:WEST STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01266-9236
Practice Address - Country:US
Practice Address - Phone:413-496-0701
Practice Address - Fax:413-232-6136
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA183317363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1852191Medicaid
MANS0068Medicare ID - Type UnspecifiedMEDICARE PROVIDER