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Individual

MS. KRISTINE MARIE WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
232 S MAIN ST STE A, CULVER, IN 46511
(574) 335-7780
(574) 335-0730
Mailing address
707 CEDAR ST STE 200, SOUTH BEND, IN 46617-2057
(574) 335-8707

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002758A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000878284
BCBS
IN
01
000001170309
BCBS (ELM RD)
IN
01
187720061
MEDICARE
IN
05
200936570
IN
01
P01942591
RR MEDICARE
IN
Enumeration date
09/23/2008
Last updated
09/12/2025
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