Healthcare Provider Details

I. General information

NPI: 1184193427
Provider Name (Legal Business Name): MEGAN M WEAVER BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E CHAPMAN AVE STE 10
ORANGE CA
92866-2237
US

IV. Provider business mailing address

1215 E CHAPMAN AVE STE 10
ORANGE CA
92866-2237
US

V. Phone/Fax

Practice location:
  • Phone: 714-916-9045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number579617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: