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Individual
MS. KELLY ANN WEAVER
Active
Individual
MS. KELLY ANN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP, ARNP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
413453
NY
363LF0000X
Family Nurse Practitioner
Primary
F330977
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03314050
—
NY
Enumeration date
03/23/2007
Last updated
08/13/2024
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