Provider Demographics
NPI:1568731313
Name:WEAVER, MARIANNE (RN SCHOOL NURSE)
Entity Type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:RN SCHOOL NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221-225 VIOLET AVENUE
Mailing Address - Street 2:VIOLET AVENUE ELEMENTARY SCHOOL
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:485-486-4499
Mailing Address - Fax:845-486-7796
Practice Address - Street 1:191 VIOLET AVE
Practice Address - Street 2:VIOLET AVENUE ELEMENTARY SCHOOL
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1527
Practice Address - Country:US
Practice Address - Phone:845-486-4499
Practice Address - Fax:845-486-7796
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252383-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool