Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | SP016960 | PA |
NPI | 1023552221 |
---|---|
Provider Name | Valerie Weyand |
First Address | Beaver, PA 15009-1713 |
Second Address | Sharon, PA 16146-2004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2016 |
Last Update Date | 01/02/2017 |