Individual
MRS. BIANCA GRACIELA WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
9880 ANGIES WAY STE 350, LOUISVILLE, KY 40241-2852
(502) 423-9595
(502) 719-0161
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5754
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
3012061
KY
367A00000X
Advanced Practice Midwife
Primary
3012061
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300013135
—
IN
05
—
7100516470
—
KY
Enumeration date
02/20/2018
Last updated
10/29/2020
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