MEDICARE: MRS. EULA DORINE WEAVER APRN-C

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	363LG0600X	Gerontology Nurse Practitioner	ARNP9343639	FL
2	363LA2200X	Adult Health Nurse Practitioner	ARNP9343639	FL
3	163W00000X	Registered Nurse	RN9343639	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336552579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EULA DORINE WEAVER APRN-C

Provider Business Mailing Address
First Line	:	3551 S BLAIR STONE RD STE 128186
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32301-8826
Country	:	US
Telephone Number	:	448-243-5962
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 APALACHEE PKWY STE 307
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32301-3629
Country	:	US
Telephone Number	:	448-243-5962
Fax Number	:

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

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	04/08/2026

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