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Individual
MS. LISA ANN WEAVER
Active
Individual
MS. LISA ANN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6319
TN
363LF0000X
Family Nurse Practitioner
79070
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659447654
NPI GROUP NUMBER
—
05
—
3344019
—
TN
01
—
3710887
MEDICARE GROUP NUMBER
TN
Enumeration date
06/16/2005
Last updated
10/09/2009
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