| Kenan Weidner, | |
| 313 Autumn Harvest Lane, Lititz, PA 17543 | |
| (610) 780-1523 | |
| Not Available | 
| Full Name | Kenan Weidner | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Practitioner - Family | 
| Location | 313 Autumn Harvest Lane, Lititz, Pennsylvania | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1538980313 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | SP030911 (Pennsylvania) | Primary | 
| Entity Name | Creek Medical Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1376929679 PECOS PAC ID: 7315257540 Enrollment ID: O20151030000839 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Kenan Weidner, 313 Autumn Harvest Lane, Lititz, PA 17543 Ph: (610) 780-1523 | Kenan Weidner, 313 Autumn Harvest Lane, Lititz, PA 17543 Ph: (610) 780-1523 | 
| Ahna D Fulmer, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1500 Highlands Dr, Lititz, PA 17543 Phone: 717-988-0000 Fax: 717-782-5716 | |
| Brock Cromleigh, CRNP, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 562 W 2nd Ave, Lititz, PA 17543 Phone: 717-626-2167 | |
| Leah Michelle Ortiz,  Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 640 E Oregon Rd, Lititz, PA 17543 Phone: 717-569-8773 Fax: 717-569-8187 | |
| Nicole Shaffer, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6 W Newport Rd, Lititz, PA 17543 Phone: 717-627-2108 | |
| Mrs. Kayla Lee Beard, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1500 Highlands Dr, Lititz, PA 17543 Phone: 717-568-8865 Fax: 717-231-8756 | |
| Megan E Jones, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 101 W Airport Rd, Lititz, PA 17543 Phone: 717-466-2445 Fax: 717-466-2447 | |
| Michele O'neill, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 101 W Airport Rd, Lititz, PA 17543 Phone: 717-466-2445 Fax: 717-466-2447 |