Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LMW029 | SC |
NPI | 1134187123 |
---|---|
Provider Name | Linda Kay Weaver |
First Address | Spartanburg, SC 29307-1048 |
Second Address | Spartanburg, SC 29307-1048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 09/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LM0013 | (05) | SC |