Provider Demographics
NPI:1871011668
Name:WEISS, KIRSTEN ELISE (CRNP)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:ELISE
Last Name:WEISS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:1886 ROHRERSTOWN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2322
Practice Address - Country:US
Practice Address - Phone:717-735-1920
Practice Address - Fax:717-735-1921
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP017862363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103417060Medicaid
PASP017862OtherSTATE LICENSE - CRNP
PARN333732LOtherSTATE LICENSE - RN
14141160OtherCAQH
14141160OtherCAQH