Individual
NICKOL WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
25 CROSSROADS DR STE 10, OWINGS MILLS, MD 21117-5473
(410) 415-5105
Mailing address
6020 RICHMOND HWY STE 102, ALEXANDRIA, VA 22303-2157
(410) 977-5128
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R187292
MD
Other
Enumeration date
12/06/2021
Last updated
03/19/2024
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