Provider Demographics
NPI:1356890008
Name:WEAVER, LINDSEY REBECCA (APRN)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:REBECCA
Last Name:WEAVER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 W HIGHWAY 378 HANNAH
Mailing Address - Street 2:
Mailing Address - City:PAMPLICO
Mailing Address - State:SC
Mailing Address - Zip Code:29583-5315
Mailing Address - Country:US
Mailing Address - Phone:843-601-0128
Mailing Address - Fax:
Practice Address - Street 1:401 E CHEVES ST STE 302
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2615
Practice Address - Country:US
Practice Address - Phone:843-777-7255
Practice Address - Fax:843-679-6883
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily