Provider Demographics
NPI:1902207921
Name:WEAVER, LINDSEY ELIZABETH MARY (PHARMD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ELIZABETH MARY
Last Name:WEAVER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4323 HARRISON ST APT 29
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-8437
Mailing Address - Country:US
Mailing Address - Phone:501-467-2981
Mailing Address - Fax:
Practice Address - Street 1:3150 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7515
Practice Address - Country:US
Practice Address - Phone:870-793-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist