Provider Demographics
NPI:1396199261
Name:WEAVER, KATHERINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27328 DELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1351
Mailing Address - Country:US
Mailing Address - Phone:440-785-3551
Mailing Address - Fax:
Practice Address - Street 1:27328 DELLWOOD DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1351
Practice Address - Country:US
Practice Address - Phone:440-785-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN225647163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health