Individual
MS. PHYLLIS MARIE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH,M.A.,B.S.,B.A.
Contact information
Practice address
3555 AIRLINE BLVD, PORTSMOUTH, VA 23701-2642
(757) 465-7914
Mailing address
3555 AIRLINE BLVD, PORTSMOUTH, VA 23701-2642
(757) 465-7914
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202009552
VA
183500000X
Pharmacist
10650
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202009552
PHARMACIST LICENSE
VA
01
—
10650
PHARMACIST LICENSE
NC
Enumeration date
08/20/2010
Last updated
10/12/2021
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