Weaver, Sandra

Weaver, Sandra is an individual health care provider with primary practice located at 810 W Forest Ave , Jackson TN 38301-3942. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Weaver, Sandra can be contacted via phone (731) 668-1853.

Contact Information

Primary practice address
810 W Forest Ave Jackson TN 38301-3942
Phone: (731) 668-1853
Fax: (731) 664-7731
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 50394 Tennessee

Profile Details

NPI number 1295705358
LBN Legal business name Weaver, Sandra
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Feb 14th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295705358 NPPES
Tennessee MEDICAID 3621833

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