Provider Demographics
NPI:1245588219
Name:WEAVER, FELICIA ZOHNETTA
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ZOHNETTA
Last Name:WEAVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 OCEANVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3906
Mailing Address - Country:US
Mailing Address - Phone:907-491-1158
Mailing Address - Fax:
Practice Address - Street 1:1111 OCEANVIEW DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3906
Practice Address - Country:US
Practice Address - Phone:907-491-1158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-24
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant