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General NPI Number Information
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NPI Number | 1093784514
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Entity Type | Individual
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Provider Name | AUDREY LISA WEAVER CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 605 S GEORGE ST STE 200
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City | YORK
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State | PA
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Zip | 17401-3160
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Country | US
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Telephone | 717-851-2334
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Fax | 717-851-3498
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Provider Business Mailing Address
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Address Line | 1803 MOUNT ROSE AVE STE B3
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City | YORK
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State | PA
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Zip | 17403-3026
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Country | US
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Telephone | 717-851-6816
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Fax | 717-851-6892
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP006990B
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License Number State | PA
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