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Individual

DR. JERRIE CAROLINE HANEY-WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
501 19TH STREET, SUITE 509, KNOXVILLE, TN 37916-1853
(865) 524-3208
(865) 522-4322
Mailing address
501 19TH STREET, SUITE 509, KNOXVILLE, TN 37916-1853
(865) 524-3208
(865) 522-4322

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
40791
TN
207VX0000X
Obstetrics Physician
MD40791
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1154546927
GROUP NPI NUMBER
TN
05
3832868
TN
01
4131926
BLUE CROSS BLUE SHIELD
Enumeration date
07/17/2006
Last updated
11/08/2010
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