Healthcare Provider Details

I. General information

NPI: 1417903972
Provider Name (Legal Business Name): ALICE MARIE WEINREB CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 S ARLINGTON ST
AKRON OH
44306-3527
US

IV. Provider business mailing address

1130 S ARLINGTON ST
AKRON OH
44306-3527
US

V. Phone/Fax

Practice location:
  • Phone: 330-622-4342
  • Fax: 330-724-1485
Mailing address:
  • Phone: 330-622-4342
  • Fax: 330-724-1485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN137050
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: