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General NPI Number Information
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NPI Number | 1992973374
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Entity Type | Individual
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Provider Name | EVELYN JEAN WIEST-KERTZ M.S. CCC-A
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Gender | Female
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 208 POINT PLZ
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City | BUTLER
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State | PA
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Zip | 16001-2552
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Country | US
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Telephone | 724-283-3984
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Fax | 724-283-3796
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Provider Business Mailing Address
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Address Line | 208 POINT PLZ
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City | BUTLER
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State | PA
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Zip | 16001-2552
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Country | US
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Telephone | 724-283-3984
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Fax | 724-283-3796
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AT000515L
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License Number State | PA
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