Provider Demographics
NPI:1851095103
Name:WEBER, VIRGINIA IMANI
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:IMANI
Last Name:WEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 JEAN AVE APT SUITE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-1722
Mailing Address - Country:US
Mailing Address - Phone:330-431-0522
Mailing Address - Fax:
Practice Address - Street 1:822 JEAN AVE APT SUITE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1722
Practice Address - Country:US
Practice Address - Phone:330-431-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home