Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 2958 | CA |
NPI | 1063570372 |
---|---|
Provider Name | Ms. Linda Weaver |
First Address | San Francisco, CA 94118-1618 |
Second Address | San Francisco, CA 94118-1618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 17/06/2010 |