Provider Demographics
NPI:1316667553
Name:WEBER, LINDSEY RENEE (CRNA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RENEE
Last Name:WEBER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 GRAYS LN
Mailing Address - Street 2:
Mailing Address - City:KINGSLEY
Mailing Address - State:MI
Mailing Address - Zip Code:49649-9332
Mailing Address - Country:US
Mailing Address - Phone:231-357-2429
Mailing Address - Fax:
Practice Address - Street 1:1651 GRAYS LN
Practice Address - Street 2:
Practice Address - City:KINGSLEY
Practice Address - State:MI
Practice Address - Zip Code:49649-9332
Practice Address - Country:US
Practice Address - Phone:231-357-2429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704348695163W00000X
MI0000000000000000367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse