NPI | 1851390918 |
---|---|
Former Name | LONNA L WEAVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71001597A) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP 9425102) |
Enumeration Date | 2005-07-20 |
Last Update Date | 2023-02-28 |