Healthcare Provider Details

I. General information

NPI: 1518750041
Provider Name (Legal Business Name): WEAVER HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6471 CARRIAGE WAY
CORCORAN MN
55340-4445
US

IV. Provider business mailing address

6471 CARRIAGE WAY
CORCORAN MN
55340-4445
US

V. Phone/Fax

Practice location:
  • Phone: 763-742-7593
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: UCHECHI AMAJUOYI
Title or Position: ADULT GERIATRIC NURSE PRACTITIONER
Credential: NP
Phone: 763-742-7593