MEDICARE: CATHARINE LINDSAY WEAVER PNP

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
1	208000000X	Pediatrics Physician	25017	SC
2	363LP0200X	Pediatric Nurse Practitioner	25017	SC

General Provider Information

NPI Number	:	1093473068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHARINE LINDSAY WEAVER PNP

Provider Business Mailing Address
First Line	:	430 WATERSEDGE DR
Second Line	:
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585-6426
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2047 COMSTOCK AVE
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-8117
Country	:	US
Telephone Number	:	843-709-5989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2021
Last Update Date	:	09/02/2025

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