Individual
LAURA L WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1617 SHERMAN AVE, MADISON, WI 53704-5930
(800) 963-0035
Mailing address
1617 SHERMAN AVE, MADISON, WI 53704-5930
(800) 963-0035
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7404-33
WI
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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