Healthcare Provider Details

I. General information

NPI: 1053511717
Provider Name (Legal Business Name): BARBARA A. WEAVER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W WATER ST HARRISONBURG-ROCKINGHAM FREE CLINIC
HARRISONBURG VA
22801-3624
US

IV. Provider business mailing address

1491 VIRGINIA AVE APT #317
HARRISONBURG VA
22802-2433
US

V. Phone/Fax

Practice location:
  • Phone: 540-433-5431
  • Fax: 540-574-0207
Mailing address:
  • Phone: 540-437-4346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024167729
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: