Healthcare Provider Details

I. General information

NPI: 1538823810
Provider Name (Legal Business Name): LEAH MARIE WEIDNER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH MARIE MARCHANTI

II. Dates (important events)

Enumeration Date: 10/23/2021
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W CENTRE ST
MAHANOY CITY PA
17948-2505
US

IV. Provider business mailing address

201 W CENTRE ST
MAHANOY CITY PA
17948-2505
US

V. Phone/Fax

Practice location:
  • Phone: 272-639-5710
  • Fax:
Mailing address:
  • Phone: 272-639-5710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP024509
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: