Provider Demographics
NPI:1689823528
Name:WEINBERGER, ELLEN BINDER (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:BINDER
Last Name:WEINBERGER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 LASALLE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8148
Mailing Address - Country:US
Mailing Address - Phone:770-649-0472
Mailing Address - Fax:
Practice Address - Street 1:220 COBB PKWY N
Practice Address - Street 2:SUITE 400
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-3581
Practice Address - Country:US
Practice Address - Phone:678-420-5245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN128678NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily