Individual
DANIELLE JEAN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12441 SHREVE RD, BIG PRAIRIE, OH 44611-9704
(330) 749-7058
Mailing address
12441 SHREVE RD, BIG PRAIRIE, OH 44611-9704
(330) 749-7058
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN115711
OH
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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