Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 159467 | NC |
NPI | 1346738184 |
---|---|
Provider Name | Nicole Lowe Weaver |
First Address | Greensboro, NC 27455-2464 |
Second Address | Greensboro, NC 27408-7021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2018 |
Last Update Date | 26/04/2018 |