Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 0024173360 | VA |
NPI | 1023478054 |
---|---|
Provider Name | Sarah Weber |
First Address | Arlington, TX 76016-2327 |
Second Address | Bedford, TX 76022-6882 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2016 |
Last Update Date | 13/06/2021 |