Provider Demographics
NPI:1669413894
Name:WEAVER, VALERIE B (APRNBC)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:B
Last Name:WEAVER
Suffix:
Gender:F
Credentials:APRNBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 570
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:MO
Mailing Address - Zip Code:64776-0570
Mailing Address - Country:US
Mailing Address - Phone:417-646-8123
Mailing Address - Fax:
Practice Address - Street 1:101 GIESLER DRIVE
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:MO
Practice Address - Zip Code:64776
Practice Address - Country:US
Practice Address - Phone:417-646-8123
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO52112363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000781OtherFAMILY HEALTH PARTNERS
MO226753OtherHEALTHLINK
MO33119018OtherBLUE CROSS BLUE SHIELD
MO357150OtherFIRST GUARD MC
MO43543OtherHEALTHCARE USA MC
MO000781OtherFAMILY HEALTH PARTNERS
MOS09917Medicare UPIN
MO0009926AMedicare ID - Type UnspecifiedTOPEKA, KANSAS