Healthcare Provider Details

I. General information

NPI: 1033662762
Provider Name (Legal Business Name): CHRISTY WEIKER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2016
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 TRANSVERSE DR
TOLEDO OH
43614-8008
US

IV. Provider business mailing address

3355 GLENDALE AVE FL 3
TOLEDO OH
43614-2426
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-3787
  • Fax: 419-383-6046
Mailing address:
  • Phone: 419-383-3787
  • Fax: 419-383-6046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.019498
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN.291002
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: