Provider Demographics
NPI:1619557055
Name:WEAVER, SIERRA N (MSN APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:N
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MSN APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 METROPOLITAN AVE SE APT 222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1983
Mailing Address - Country:US
Mailing Address - Phone:762-436-9273
Mailing Address - Fax:
Practice Address - Street 1:965 JOE FRANK HARRIS PKWY SE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2130
Practice Address - Country:US
Practice Address - Phone:678-721-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN255118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily