Provider Demographics
NPI:1386028934
Name:WEINGARTEN, ABIGAIL (LPN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:WEINGARTEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 ALTON ST APT 115
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-3116
Mailing Address - Country:US
Mailing Address - Phone:651-274-6630
Mailing Address - Fax:
Practice Address - Street 1:1322 ALTON ST APT 115
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3116
Practice Address - Country:US
Practice Address - Phone:651-274-6630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL 78847-4164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse