Healthcare Provider Details

I. General information

NPI: 1780113928
Provider Name (Legal Business Name): HEATHER L WEISS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2017
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2823 PARKWAY BLVD
ALLENTOWN PA
18104-5362
US

IV. Provider business mailing address

2823 PARKWAY BLVD
ALLENTOWN PA
18104-5362
US

V. Phone/Fax

Practice location:
  • Phone: 484-554-7684
  • Fax:
Mailing address:
  • Phone: 484-554-7684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number26NR14611400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN610450
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP028828
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: