Provider Demographics
NPI:1316150360
Name:WEAVER, MELANIE ANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:ANNE
Last Name:WEAVER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMANA
Mailing Address - State:IA
Mailing Address - Zip Code:52203-8229
Mailing Address - Country:US
Mailing Address - Phone:319-622-3341
Mailing Address - Fax:319-622-3307
Practice Address - Street 1:507 39TH AVE
Practice Address - Street 2:
Practice Address - City:AMANA
Practice Address - State:IA
Practice Address - Zip Code:52203-8229
Practice Address - Country:US
Practice Address - Phone:319-622-3341
Practice Address - Fax:319-622-3307
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18994183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist