Provider Demographics
NPI:1619315165
Name:WEIMER, CHRISTINE HOVORKA (MN FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:HOVORKA
Last Name:WEIMER
Suffix:
Gender:F
Credentials:MN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 WALNUT GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-3710
Mailing Address - Country:US
Mailing Address - Phone:626-302-0179
Mailing Address - Fax:626-302-6111
Practice Address - Street 1:1515 WALNUT GROVE AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-3710
Practice Address - Country:US
Practice Address - Phone:626-302-0179
Practice Address - Fax:626-302-6111
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN342485363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health