Individual
ZACHARY JAMES WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1721 MAGNAVOX WAY, FORT WAYNE, IN 46804-1537
(260) 748-3650
Mailing address
6103 S HARMON ST, MARION, IN 46953-5809
(765) 618-7049
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71010967A
IN
Other
Enumeration date
03/29/2021
Last updated
04/02/2021
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