Carly Jean Weaver
Nurse Practitioner in Temple Terrace, FL. Individual provider (NPI-1).
NPI number1629637293
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1629637293
- Entity type
- Individual (NPI-1)
- Name
- Carly Jean Weaver
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2019
- Certification date
- Aug 3, 2020
- Last updated
- Mar 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | APRN11001578 | FL | Yes |
| 363LP0200X | Nurse Practitioner, Pediatrics | 11001578 | FL |
Practice location
12470 Telecom Dr Ste 300wTemple Terrace, FL 33637-0904
Phone 813-871-8200 · Fax 813-357-5501
Mailing address
12470 Telecom Dr Ste 300wTemple Terrace, FL 33637-0904
Phone 813-871-8183 · Fax 813-871-8184
Other practice locations
3003 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Tampa, FL 33607-6307
Phone 813-871-8200
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