Individual
MRS. BETHANY WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
113 HOWARD ST STE 101, LA PLATA, MD 20646-6950
(301) 392-0400
Mailing address
43438 GREG ST, HOLLYWOOD, MD 20636-3303
(717) 894-0156
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R222546
MD
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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