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NPI Code Detail

MEDICARE: FRANCES WEAVER GRILL FNP

MEDICARE: FRANCES WEAVER GRILL FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP0887AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679790174
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANCES WEAVER GRILL FNP
Provider Business Mailing Address
First Line : 801 W REX ALLEN DR
Second Line :
City : WILLCOX
State : AZ
Zip : 85643-1129
Country : US
Telephone Number : 520-766-5000
Fax Number : 520-766-5001
Provider Business Practice Location Address
First Line : 801 W REX ALLEN DR
Second Line :
City : WILLCOX
State : AZ
Zip : 85643-1129
Country : US
Telephone Number : 520-766-5000
Fax Number : 520-766-5001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 11/04/2011

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Directions to “ FRANCES WEAVER GRILL FNP” Practice Location

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