Individual
EDITH ELAINE WEATHERFORD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1414 W FAIR AVE, #226, MARQUETTE, MI 49855-2675
(906) 225-3925
(906) 225-4838
Mailing address
1414 W FAIR AVE, #226, MARQUETTE, MI 49855-2675
(906) 225-3925
(906) 225-4838
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704161015
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4135841
—
MI
Enumeration date
08/18/2005
Last updated
07/08/2007
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