Provider Demographics
NPI:1801354527
Name:WEBER, CHRISTIE ANNE (RNFA)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:ANNE
Last Name:WEBER
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:ANNE
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RNFA
Mailing Address - Street 1:665 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1104
Mailing Address - Country:US
Mailing Address - Phone:716-845-8849
Mailing Address - Fax:
Practice Address - Street 1:665 ELM ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1104
Practice Address - Country:US
Practice Address - Phone:716-845-8849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY690082163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY690082OtherREGISTERED NURSE