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NPI Code Detail

MEDICARE: GLYNIS WEAVER PA-C

MEDICARE: GLYNIS WEAVER PA-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
1363AM0700XMedical Physician AssistantPA1677NV
2363A00000XPhysician AssistantPA-2598ID

General Provider Information

NPI Number : 1649674276
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLYNIS WEAVER PA-C
Provider Business Mailing Address
First Line : 1600 MEDICAL PKWY
Second Line :
City : CARSON CITY
State : NV
Zip : 89703-4625
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1600 MEDICAL PKWY
Second Line :
City : CARSON CITY
State : NV
Zip : 89703-4625
Country : US
Telephone Number : 775-445-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2014
Last Update Date : 03/03/2026

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Directions to “ GLYNIS WEAVER PA-C” Practice Location

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