Provider Demographics
NPI:1336552579
Name:WEAVER, EULA DORINE (APRN-C)
Entity Type:Individual
Prefix:MRS
First Name:EULA
Middle Name:DORINE
Last Name:WEAVER
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5466 THOMASVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-3812
Mailing Address - Country:US
Mailing Address - Phone:850-893-8116
Mailing Address - Fax:
Practice Address - Street 1:2200 S MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-6303
Practice Address - Country:US
Practice Address - Phone:850-354-8765
Practice Address - Fax:850-900-5941
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9343639163W00000X
FLARNP9343639363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology