Provider Demographics
NPI:1689766057
Name:WEAVER, AMY CAROL (APN, RN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:CAROL
Last Name:WEAVER
Suffix:
Gender:F
Credentials:APN, RN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:CAROL
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:695 KELLER RD
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:TN
Mailing Address - Zip Code:37616-6421
Mailing Address - Country:US
Mailing Address - Phone:423-798-1749
Mailing Address - Fax:423-798-1755
Practice Address - Street 1:810 CHURCH
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745
Practice Address - Country:US
Practice Address - Phone:423-798-1749
Practice Address - Fax:423-798-1755
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily