Individual
MR. TYLER NATHAN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
3400 OLENTANGY RIVER RD, COLUMBUS, OH 43202-1523
(614) 754-5500
(614) 457-9519
Mailing address
3400 OLENTANGY RIVER RD, COLUMBUS, OH 43202-1523
(614) 754-5500
(614) 457-9519
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.402950
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.022337
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0264322
—
OH
01
—
14125201
CAQH
—
Enumeration date
10/23/2017
Last updated
11/06/2023
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