Individual
MRS. JUDY E WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRNBC
Contact information
Practice address
1007 GREENFIELD DR, TIFTON, GA 31794-3795
(229) 382-9733
(229) 387-6161
Mailing address
907 18TH ST E STE 400, TIFTON, GA 31794-3684
(229) 353-3422
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
R089815
GA
363LF0000X
Family Nurse Practitioner
Primary
RN089815
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00844368A
—
GA
Enumeration date
03/17/2006
Last updated
04/06/2021
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