Individual
ANN MARIE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2217 N POWER RD APT 3030, MESA, AZ 85215-2983
(417) 379-3355
Mailing address
2217 N POWER RD APT 3030, MESA, AZ 85215-2983
(417) 379-3355
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1035016
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1035016
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
11/30/2021
Last updated
11/30/2021
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