Healthcare Provider Details

I. General information

NPI: 1700991056
Provider Name (Legal Business Name): SHEILA R WEISSENBERGER BSN, MPH, APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BUTLER AVE MENTAL HEALTH SERVICE
MARTINSBURG WV
25401-9990
US

IV. Provider business mailing address

510 BUTLER AVE MENTAL HEALTH SERVICE
MARTINSBURG WV
25401-9990
US

V. Phone/Fax

Practice location:
  • Phone: 304-263-0811
  • Fax: 304-262-1417
Mailing address:
  • Phone: 304-263-0811
  • Fax: 304-262-1417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number0001064768
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: