Provider Demographics
NPI:1134393838
Name:WEAVER, VEORNIA
Entity type:Individual
Prefix:MS
First Name:VEORNIA
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMMANDER , DDEAMC
Mailing Address - Street 2:CONNELLY HEALTH CLINIC ATT: MCHF - DFCM - CHC
Mailing Address - City:FT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5650
Mailing Address - Country:US
Mailing Address - Phone:706-787-5174
Mailing Address - Fax:706-787-5145
Practice Address - Street 1:COMMANDER , DDEAMC
Practice Address - Street 2:CONNELLY HEALTH CLINIC ATT: MCHF - DFCM - CHC
Practice Address - City:FT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5650
Practice Address - Country:US
Practice Address - Phone:706-787-5174
Practice Address - Fax:706-787-5145
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN066828164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse