Provider Demographics
NPI:1821028598
Name:WEYANT, ELLEN LOUISE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:LOUISE
Last Name:WEYANT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-633-1433
Mailing Address - Fax:717-633-1838
Practice Address - Street 1:3130 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-9134
Practice Address - Country:US
Practice Address - Phone:717-633-1433
Practice Address - Fax:717-633-1838
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP002047G363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1551704OtherGATEWAY-WMG
MD644530OtherCAREFIRST MD BCBS
PA0052724OtherHIGHMARK BLUE SHIELD
PA50043535OtherCAPITAL BLUE CROSS-WMG
PA109085OtherJOHNS HOPKINS
MD644530OtherCAREFIRST MD BCBS
PAP00280222Medicare PIN
R05834Medicare UPIN