Provider Demographics
NPI:1164792230
Name:WEINER, NANCY E (RN)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:E
Last Name:WEINER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HIGH GATE DRIVE
Mailing Address - Street 2:MINNESAUKE ELEMENTARY SCHOOL
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733
Mailing Address - Country:US
Mailing Address - Phone:631-730-4210
Mailing Address - Fax:631-730-4213
Practice Address - Street 1:21 HIGH GATE DR
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1877
Practice Address - Country:US
Practice Address - Phone:631-730-4210
Practice Address - Fax:631-730-4213
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363615-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool