Provider Demographics
NPI:1205338258
Name:WEBER, CRICKET (RN)
Entity type:Individual
Prefix:
First Name:CRICKET
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 PRIVATE ROAD 6307
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:TX
Mailing Address - Zip Code:75773-7911
Mailing Address - Country:US
Mailing Address - Phone:903-780-2822
Mailing Address - Fax:
Practice Address - Street 1:555 PRIVATE ROAD 6307
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:TX
Practice Address - Zip Code:75773
Practice Address - Country:US
Practice Address - Phone:903-780-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX842928163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics