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General NPI Number Information
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NPI Number | 1780677245
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Entity Type | Individual
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Provider Name | DIANE J WEISENBERGER CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/30/2005
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 33100 CLEVELAND CLINIC BLVD
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City | AVON
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State | OH
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Zip | 44011-1390
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Country | US
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Telephone | 440-695-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 901681
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City | CLEVELAND
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State | OH
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Zip | 44190-1681
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Country | US
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Telephone | 440-233-8181
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Fax | 440-233-8182
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | NA01069
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | NA01069
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License Number State | OH
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