# MISS LYDIA M WEAVER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1457585234
- **Gender:** F
- **Credential:** APRN-CNP, PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | RN.335652 | OH | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 28264 | SC | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | APRN.CNP.0033630 | OH | — |

## Other

- **Enumeration date:** 05/08/2009
- **Last updated:** 03/12/2024