Provider Demographics
NPI:1194101972
Name:WEGHORST, EMILY R (APRN-CNP)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:R
Last Name:WEGHORST
Suffix:
Gender:F
Credentials:APRN-CNP
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Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:MLC 2003
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4432
Mailing Address - Fax:513-636-3952
Practice Address - Street 1:3333 BURNET AVE.
Practice Address - Street 2:MLC 2003
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4432
Practice Address - Fax:513-636-3952
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001131363L00000X, 363L00000X
OHAPRN.CNP.17893363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102527800Medicaid