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General NPI Number Information
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NPI Number | 1356344329
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Entity Type | Individual
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Provider Name | BRANDEN LLOYD WEISGARBER PHD, CRNP
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1261 WOOSTER RD STE 140
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City | MILLERSBURG
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State | OH
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Zip | 44654-1569
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Country | US
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Telephone | 330-674-9675
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Fax |
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Provider Business Mailing Address
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Address Line | 1213 RUSSELL DR NW
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City | BOLIVAR
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State | OH
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Zip | 44612-8418
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Country | US
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Telephone | 330-878-5627
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP04723
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License Number State | OH
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