Provider Demographics
NPI:1619314663
Name:WEAVER, JULIA KAY (LM, CPM)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:KAY
Last Name:WEAVER
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NOXON
Mailing Address - State:MT
Mailing Address - Zip Code:59853-9775
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:NOXON
Practice Address - State:MT
Practice Address - Zip Code:59853-9775
Practice Address - Country:US
Practice Address - Phone:406-847-6407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT49176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife