Provider Demographics
NPI:1184846594
Name:WEIGEL, JANE MARIE (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:MARIE
Last Name:WEIGEL
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 WILLOW STREET PIKE
Mailing Address - Street 2:
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-9225
Mailing Address - Country:US
Mailing Address - Phone:717-380-8312
Mailing Address - Fax:717-464-0890
Practice Address - Street 1:2421 WILLOW STREET PIKE
Practice Address - Street 2:
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584-9225
Practice Address - Country:US
Practice Address - Phone:717-380-8312
Practice Address - Fax:717-464-0890
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN285307L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018561050001Medicare ID - Type Unspecified