Provider Demographics
NPI:1497133144
Name:WEAVER, CORINNA (CRNP)
Entity Type:Individual
Prefix:
First Name:CORINNA
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CORINNA
Other - Middle Name:
Other - Last Name:FLEEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL WAY
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4670
Mailing Address - Country:US
Mailing Address - Phone:724-841-4402
Mailing Address - Fax:
Practice Address - Street 1:389 NEW CASTLE RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1743
Practice Address - Country:US
Practice Address - Phone:724-282-2216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN595818363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103036340Medicaid
PA433137Medicare Oscar/Certification