Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 8742 | CA |
NPI | 1073578167 |
---|---|
Provider Name | Ms. Kristin Weaver |
First Address | San Francisco, CA 94121-1545 |
Second Address | San Francisco, CA 94121-1545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 17/07/2007 |