Individual
DEANNA ELIZABETH WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 W STATE HIGHWAY 152, MUSTANG, OK 73064-3902
(405) 376-3340
Mailing address
106 W STATE HIGHWAY 152, MUSTANG, OK 73064
(405) 376-3340
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
113960
OK
Other
Enumeration date
08/12/2020
Last updated
04/01/2021
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