Provider Demographics
NPI:1619077401
Name:WEANER, BARBARA (CFNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:WEANER
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:BOYLE
Other - Last Name:WEANER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, FNP
Mailing Address - Street 1:PO BOX 9165
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-9165
Mailing Address - Country:US
Mailing Address - Phone:304-636-6144
Mailing Address - Fax:304-636-4754
Practice Address - Street 1:ONE MEDICAL CENTER DRIVE
Practice Address - Street 2:ROBERT C BYRD HEALTH SCIENCE CENTER
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506
Practice Address - Country:US
Practice Address - Phone:304-636-6144
Practice Address - Fax:304-636-4754
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV39521363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0159918000Medicaid
S60855Medicare UPIN
WVWENP10354Medicare ID - Type Unspecified