Provider Demographics
NPI:1356991004
Name:WEAVER, AMELIA ANN
Entity type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:ANN
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 1:2622 OAK GROVE CH. RD AMELIA ANN WEAVER
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501
Mailing Address - Country:US
Mailing Address - Phone:919-868-1763
Mailing Address - Fax:919-639-4522
Practice Address - Street 1:2622 OAK GROVE CH. RD AMELIA ANN WEAVER
Practice Address - Street 2:
Practice Address - City:ANGIER
Practice Address - State:NC
Practice Address - Zip Code:27501
Practice Address - Country:US
Practice Address - Phone:919-868-1763
Practice Address - Fax:919-639-4522
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider