Provider Demographics
NPI:1861823791
Name:WEIR, CHRISTINA N (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:N
Last Name:WEIR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 W BETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5407
Mailing Address - Country:US
Mailing Address - Phone:800-622-6575
Mailing Address - Fax:765-284-7738
Practice Address - Street 1:2610 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-9684
Practice Address - Country:US
Practice Address - Phone:800-622-6575
Practice Address - Fax:765-642-7903
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001597A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300017114Medicaid
INP02198224OtherMEDICARE RR