Provider Demographics
NPI:1508465543
Name:WEIRAUCH, ABIGAIL (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:WEIRAUCH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12523 RATHBUN RD
Mailing Address - Street 2:
Mailing Address - City:BIRCH RUN
Mailing Address - State:MI
Mailing Address - Zip Code:48415-9799
Mailing Address - Country:US
Mailing Address - Phone:989-798-1669
Mailing Address - Fax:
Practice Address - Street 1:154 S MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-1692
Practice Address - Country:US
Practice Address - Phone:989-502-1122
Practice Address - Fax:989-502-1212
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704318806163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse