Provider Demographics
NPI:1326602830
Name:WEAVER, AMBER (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 BIMINI DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-5120
Mailing Address - Country:US
Mailing Address - Phone:907-617-0333
Mailing Address - Fax:
Practice Address - Street 1:4455 BIMINI DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-5120
Practice Address - Country:US
Practice Address - Phone:907-617-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide