Individual
JESSICA WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
919 W BARROW DR, CHANDLER, AZ 85225-2151
(480) 477-4236
(480) 687-2919
Mailing address
919 W BARROW DR, CHANDLER, AZ 85225-2151
(480) 477-4236
(480) 687-2919
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
RN177767
AZ
376G00000X
Nursing Home Administrator
Primary
ALM-011711
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-4751447
82-4751447
AZ
Enumeration date
09/02/2019
Last updated
09/02/2019
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