Individual
SUSAN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1723 BROADWAY ST STE 410, CAPE GIRARDEAU, MO 63701-4556
(573) 332-7746
(573) 339-9709
Mailing address
1723 BROADWAY ST STE 410, CAPE GIRARDEAU, MO 63701-4556
(573) 332-7746
(573) 339-9709
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2013002280
MO
363LF0000X
Family Nurse Practitioner
Primary
2013002280
MO
Other
Enumeration date
02/14/2013
Last updated
07/21/2022
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