Individual
MISS KRISTEN RONN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4940 EASTERN AVE FL 3, BALTIMORE, MD 21224-2735
(410) 550-6766
Mailing address
4940 EASTERN AVE FL 3, BALTIMORE, MD 21224-2735
(410) 550-6766
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
450058
NY
363LA2100X
Acute Care Nurse Practitioner
430272
NY
363LA2100X
Acute Care Nurse Practitioner
R228061
MD
363LA2200X
Adult Health Nurse Practitioner
306288
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
R228061
MD
Other
Enumeration date
03/29/2013
Last updated
01/03/2018
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