Individual
KATHLEEN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 W BROADWAY AVE, MINNEAPOLIS, MN 55411-2504
(612) 895-3850
Mailing address
8444 N 90TH ST STE 100, SCOTTSDALE, AZ 85258-4437
(602) 248-8886
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
439325
MN
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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