Provider Demographics
NPI:1770889701
Name:WEAVER, BRANDI NICOLE (NP)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:NICOLE
Last Name:WEAVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:NICOLE
Other - Last Name:OUDE ALINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2340 E MEYER BLVD STE 598
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1112
Mailing Address - Country:US
Mailing Address - Phone:816-444-6888
Mailing Address - Fax:816-444-1375
Practice Address - Street 1:2340 E MEYER BLVD STE 598
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1112
Practice Address - Country:US
Practice Address - Phone:816-444-6888
Practice Address - Fax:816-444-1375
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO142855363LW0102X
KS45212363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health