Provider Demographics
NPI:1033399597
Name:WEISNER, DIANNE (APN)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:WEISNER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8423 MARKET ST
Mailing Address - Street 2:BLDG C, SUITE 300
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6778
Mailing Address - Country:US
Mailing Address - Phone:330-543-3276
Mailing Address - Fax:330-543-8489
Practice Address - Street 1:8423 MARKET ST
Practice Address - Street 2:BLDG C, SUITE 300
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6778
Practice Address - Country:US
Practice Address - Phone:330-543-3276
Practice Address - Fax:330-543-8489
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS-08270163WD0400X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WP0200XNursing Service ProvidersRegistered NursePediatrics