Individual
DR. MELODY ANN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD FNP
Contact information
Practice address
921 S 8TH AVE STOP 8101, POCATELLO, ID 83209
(208) 282-5994
(208) 282-4476
Mailing address
921 S 8TH AVE STOP 8101, POCATELLO, ID 83209-0001
(208) 282-5994
(208) 282-4476
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
55023
ID
363LF0000X
Family Nurse Practitioner
NP10764
CA
Other
Enumeration date
06/21/2007
Last updated
06/19/2018
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