MEDICARE: NATASHA PAIGE WEAVER RN

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	163WN0800X	Neuroscience Registered Nurse	RN148360	LA

General Provider Information

NPI Number	:	1811842396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA PAIGE WEAVER RN

Provider Business Mailing Address
First Line	:	3750 WILLOW WOOD DR
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-3146
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 OAK PARK BLVD
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-8900
Country	:	US
Telephone Number	:	337-494-2048
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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