Provider Demographics
NPI:1790285849
Name:MM HEALTH APRN-CNP PLLC
Entity Type:Organization
Organization Name:MM HEALTH APRN-CNP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:405-844-3317
Mailing Address - Street 1:200 N BRYANT AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6273
Mailing Address - Country:US
Mailing Address - Phone:405-832-6881
Mailing Address - Fax:833-941-1685
Practice Address - Street 1:200 N BRYANT AVE STE 120
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6273
Practice Address - Country:US
Practice Address - Phone:405-832-6881
Practice Address - Fax:833-941-1685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty