Provider Demographics
NPI:1285896944
Name:WEISHAAR, MELANIE C (ANP)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:C
Last Name:WEISHAAR
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:CHRISTINE
Other - Last Name:ZACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:135 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209
Mailing Address - Country:US
Mailing Address - Phone:716-881-0382
Mailing Address - Fax:716-881-0422
Practice Address - Street 1:6580 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5898
Practice Address - Country:US
Practice Address - Phone:716-881-0382
Practice Address - Fax:716-881-0422
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304891363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health