Individual
DANYELLE MAY WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
527 CLAY ST, WATERTOWN, NY 13601-3701
(315) 681-0046
Mailing address
527 CLAY ST, WATERTOWN, NY 13601-3701
(315) 681-0046
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
295751
NY
Other
Enumeration date
06/15/2010
Last updated
06/15/2010
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