Provider Demographics
NPI:1821373739
Name:WEYAND, JOAN KATHLEEN (LPN)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:KATHLEEN
Last Name:WEYAND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-1716
Mailing Address - Country:US
Mailing Address - Phone:607-654-2795
Mailing Address - Fax:607-654-2798
Practice Address - Street 1:143 PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-1716
Practice Address - Country:US
Practice Address - Phone:607-654-2795
Practice Address - Fax:607-654-2798
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195154164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse