Individual
KAITLYN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2145 MORNINGSIDE DR, PENSACOLA, FL 32503-3423
(662) 678-3258
Mailing address
2145 MORNINGSIDE DR, PENSACOLA, FL 32503-3423
(662) 678-3258
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11001901
FL
363L00000X
Nurse Practitioner
Primary
APRN11001901
FL
363LG0600X
Gerontology Nurse Practitioner
903114
MS
Other
Enumeration date
02/18/2019
Last updated
12/04/2024
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