| NPI | 1619280666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE M WEAVER Owner 574-361-9338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002758A) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2010-07-20 |