Individual
MIRANDA LOUISE-KREISER WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
818 W KING ST STE 201, OWOSSO, MI 48867-2117
(989) 723-3168
(989) 725-2962
Mailing address
818 W KING ST STE 201, OWOSSO, MI 48867-2117
(989) 723-3168
(989) 725-2962
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AG01200149
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801422845
—
MI
Enumeration date
03/22/2020
Last updated
10/10/2023
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