Individual
JENNIFER ANNE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 WILLOW ST, LEBANON, PA 17046-4871
(717) 675-2561
Mailing address
300 WILLOW ST, LEBANON, PA 17046-4871
(717) 675-2561
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN507890L
PA
363LW0102X
Women's Health Nurse Practitioner
Primary
SP015404
PA
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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