Suzanne Renee Weaver, APRN
Individual provider Active NPI Family Nurse Practitioner · Corryton, TN
NPI 1164005278 · NPPES record last updated Nov 4, 2021
Key facts
- NPI
- 1164005278
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 29571 (TN)
- Practice address
- 6044 Whisper Ridge LN
Corryton, TN 37721-4147 - Phone
- (865) 582-6846
- NPI assigned
- May 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214375 | TN | MD | Registered Nurse |
| 29571 | TN | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 214375 | TN | |
| Family Nurse Practitioner | 363LF0000X | 29571 | TN | Yes |
Addresses
Primary practice location
6044 Whisper Ridge LN
Corryton, TN 37721-4147
Mailing address
6044 Whisper Ridge LN
Corryton, TN 37721-4147
Other providers in Corryton, TN
All providers in Corryton, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.