Provider Demographics
NPI:1710130570
Name:WEAVER, CINDY (LPN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 KIRKWOOD HWY STE 107
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4883
Mailing Address - Country:US
Mailing Address - Phone:302-993-7895
Mailing Address - Fax:
Practice Address - Street 1:5700 KIRKWOOD HWY STE 107
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4883
Practice Address - Country:US
Practice Address - Phone:302-993-7895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL2-0001533164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse