Provider Demographics
NPI:1346955705
Name:WEAVER, DEANA NICOLE (CNM)
Entity type:Individual
Prefix:MS
First Name:DEANA
Middle Name:NICOLE
Last Name:WEAVER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 TWIN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-5251
Mailing Address - Country:US
Mailing Address - Phone:513-344-8527
Mailing Address - Fax:
Practice Address - Street 1:41 TWIN LAKES DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5251
Practice Address - Country:US
Practice Address - Phone:513-344-8527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNM08341207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics