Individual
KELLY WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-3700
Mailing address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-3700
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NP500003542
DC
363LP0200X
Pediatric Nurse Practitioner
R245041
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R245041
MARYLAND BOARD OF NURSING
MD
Enumeration date
09/09/2020
Last updated
01/04/2024
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