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Individual

HOLLY G WEIDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP, PA

Contact information

Practice address
15 E CHESTNUT ST, AUGUSTA, ME 04330-5736
(207) 626-1561
(207) 626-1849
Mailing address
15 E CHESTNUT ST, AUGUSTA, ME 04330-5736
(207) 626-1561
(207) 626-1849

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA335
ME
363L00000X
Nurse Practitioner
Primary
AP081231
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
316490099
ME
Enumeration date
02/28/2006
Last updated
02/09/2011
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