Provider Demographics
NPI:1962873992
Name:WEIDNER, AMY JEAN (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JEAN
Last Name:WEIDNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:603 E MARKET ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-2161
Mailing Address - Country:US
Mailing Address - Phone:570-275-4962
Mailing Address - Fax:570-275-3098
Practice Address - Street 1:603 E MARKET ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-2161
Practice Address - Country:US
Practice Address - Phone:570-275-4962
Practice Address - Fax:570-275-3098
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PARN617549163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse