Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS006445E | PA |
N | 207QA0401X | Family Doctor - Addiction Medicine | OS006445E | PA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | OS006445E | PA |
NPI | 1235272899 |
---|---|
Provider Name | Dr. Jennifer Eileen Weber |
First Address | Harrisburg, PA 17104-1612 |
Second Address | Mechanicsburg, PA 17055-6171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 10/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F04422 | (02) | PA |