Provider Demographics
NPI:1487452108
Name:WEAVER, MCKENNA (CRNP)
Entity type:Individual
Prefix:
First Name:MCKENNA
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MCKENNA
Other - Middle Name:
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 E NORTH AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-6550
Mailing Address - Fax:412-359-6494
Practice Address - Street 1:320 E NORTH AVE FL 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-6550
Practice Address - Fax:412-359-6494
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN724285163W00000X
PASP032355363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse