Individual
MRS. EMILY JANE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1165 IMPERIAL DR STE 300, HAGERSTOWN, MD 21740-6556
(301) 665-9098
Mailing address
1165 IMPERIAL DR STE 300, HAGERSTOWN, MD 21740-6556
(301) 665-9098
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
R196972
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
MD
Enumeration date
02/02/2021
Last updated
12/05/2023
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