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Individual

PATRICIA WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
999 CHERAW ST, BENNETTSVILLE, SC 29512-2420
(843) 479-2341
Mailing address
201 S 5TH ST, HARTSVILLE, SC 29550-4211
(843) 857-0111

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN1313
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP0466
SC
01
P00906535
RAILROAD MEDICARE PTAN
SC
Enumeration date
08/20/2006
Last updated
09/05/2017
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