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General NPI Number Information
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NPI Number | 1922586361
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Entity Type | Individual
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Provider Name | COREY R WEAVER ARNP
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Gender | Male
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Dates
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Enumeration Date | 07/28/2018
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 9550 HICKMAN RD STE 101
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City | CLIVE
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State | IA
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Zip | 50325-5314
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Country | US
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Telephone | 515-758-8300
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Fax | 515-758-8600
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Provider Business Mailing Address
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Address Line | 9550 HICKMAN RD STE 101
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City | CLIVE
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State | IA
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Zip | 50325-5314
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Country | US
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Telephone | 515-758-8300
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Fax | 515-758-8600
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G104242
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License Number State | IA
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