Provider Demographics
NPI:1932394160
Name:WEAVER, ANA (CRNA)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:L
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-738-6618
Mailing Address - Fax:717-738-6646
Practice Address - Street 1:169 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1724
Practice Address - Country:US
Practice Address - Phone:717-738-6618
Practice Address - Fax:717-738-6646
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN528859L163W00000X, 367500000X
PA078123367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11803024OtherCAQH
PA1990968OtherHIGHMARK
PA1990968OtherFIRST PRIORITY
PA110293OtherGEISINGER
PA50072665OtherCAPITAL ADVANTAGE
PA2866253000OtherIBC
PA1579963OtherGATEWAY
PA9673462OtherAETNA
PA1027807270001Medicaid
PA9673462OtherAETNA
PA118077QCYMedicare PIN