Individual
MS. KRISTEN L MACE-WEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
(717) 228-6045
Mailing address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
(717) 228-6045
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA053430
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA053430
LICENSE
PA
Enumeration date
06/12/2008
Last updated
02/19/2020
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