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Contact Information

MELODY A WEAVER, PHD FNP
921 S 8TH AVE STOP 8101
POCATELLO, ID83209
 Phone: 208-282-5994
 Fax: 208-282-4476
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MELODY A WEAVER · (Female)

NPI # 1922204551
Status Active
Credentials PHD FNP
Entity Individual
Enumeration date 06/21/2007
Last updated 06/19/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # NP10764
  • ID License # 55023
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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