Healthcare Provider Details

I. General information

NPI: 1932394160
Provider Name (Legal Business Name): ANA WEAVER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANA L. HERNANDEZ CRNA

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 MARTIN AVE
EPHRATA PA
17522-1724
US

IV. Provider business mailing address

601 MEMORY LANE N/A
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-738-6618
  • Fax: 717-738-6646
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN528859L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number078123
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN528859L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: