Provider Demographics
NPI:1013992502
Name:WEACHTER, DENISE A (MSN CRNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:WEACHTER
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 OREGON PIKE
Mailing Address - Street 2:SUITE 107 B
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4206
Mailing Address - Country:US
Mailing Address - Phone:717-560-3505
Mailing Address - Fax:717-560-3531
Practice Address - Street 1:1725 OREGON PIKE
Practice Address - Street 2:SUITE 107 B
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4206
Practice Address - Country:US
Practice Address - Phone:717-560-3505
Practice Address - Fax:717-560-3531
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008505363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q30226Medicare UPIN
PA086110FX1Medicare ID - Type Unspecified