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General NPI Number Information
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NPI Number | 1962765552
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Entity Type | Individual
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Provider Name | JENNIFER LYNN WEIDNER M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3270 JOE BATTLE BLVD STE 275
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City | EL PASO
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State | TX
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Zip | 79938-2639
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Country | US
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Telephone | 915-271-4600
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Fax | 915-271-4601
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Provider Business Mailing Address
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Address Line | 3270 JOE BATTLE BLVD STE 275
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City | EL PASO
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State | TX
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Zip | 79938-2639
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Country | US
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Telephone | 915-271-4600
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Fax | 915-271-4601
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MT202001
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License Number State | PA
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