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Individual

LESETTA WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
540N DUKE ST 244, LANCASTER, PA 17602-2374
(717) 826-9781
(717) 945-5177
Mailing address
540N DUKE ST 244, LANCASTER, PA 17602-2374
(717) 826-9781
(717) 945-5177

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP008057
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001933875
HIGHMARK BLUE SHIELD
PA
01
1550135
GATEWAY
PA
01
50056000
CAPITAL BLUE CROSS
PA
01
NON HMO# 7424770
AETNA
PA
01
P00165180
RAILROAD MEDICARE
PA
Enumeration date
04/20/2006
Last updated
03/15/2024
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