Provider Demographics
NPI:1710321849
Name:WEIGAND, JEANA (RPH)
Entity Type:Individual
Prefix:
First Name:JEANA
Middle Name:
Last Name:WEIGAND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JEANA
Other - Middle Name:
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:561 NORWICH AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN FURNACE
Mailing Address - State:OH
Mailing Address - Zip Code:45629-8892
Mailing Address - Country:US
Mailing Address - Phone:740-354-9983
Mailing Address - Fax:740-954-9978
Practice Address - Street 1:561 NORWICH AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN FURNACE
Practice Address - State:OH
Practice Address - Zip Code:45629-8892
Practice Address - Country:US
Practice Address - Phone:740-354-9983
Practice Address - Fax:740-954-9978
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03119079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist