DANELLE WEAVER (NPI# 1477807444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477807444 |
| Entity Type | Individual |
| Full Name | DANELLE WEAVER |
| Other Name | DANIELLE WEAVER |
| Credential | ADULT NP-BC,PMHNP-BC |
| Practice Address |
4624 Park St Jacksonville FL 32205-7327 |
| Mailing Address |
5633 Clifton Ave Jacksonville FL 32211-6901 |
| Practice Telephone | 9045030131 |
| Mailing Telephone | 8508965018 |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2020-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP9227262 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
9227262 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 102378500 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Shircliff Way, Jacksonville, FL 322044748 | 9043087300 | |
| 820 Prudential Dr Ste 112, Baptist Heart Specialists, Jacksonville, FL 322078204 | 9043965996 |
| Street Address |
4624 PARK ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32205-7327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154600419 | Clifford C Burditt Jr. | Behavioral Analyst | 4624 Park St, Jacksonville, FL 32205-7327 | 2011-08-04 |
| 1104427046 | Justine Noelle Ferguson | Behavior Technician | 4624 Park St, Jacksonville, FL 32205-7327 | 2020-11-06 |
| 1356941314 | Joshua E Ordu | Behavior Technician | 4624 Park St, Jacksonville, FL 32205-7327 | 2020-10-29 |
| 1659971638 | Brooke Elizabeth Lee | Behavior Technician | 4624 Park St, Jacksonville, FL 32205-7327 | 2020-10-28 |
| 1356954275 | Madison Bernarding | Behavior Technician | 4624 Park St, Jacksonville, FL 32205-7327 | 2020-08-29 |
| 1184237133 | Samantha Sharee Hall | Behavior Technician | 4624 Park St, Jacksonville, FL 32205-7327 | 2020-08-28 |
| 1962013334 | Erica Nicole Stockwell | Behavior Technician | 4624 Park St, Jacksonville, FL 32205-7327 | 2020-08-11 |
| 1417566969 | Felicia A Beckner | Behavior Technician | 4624 Park St, Jacksonville, FL 32205-7327 | 2020-07-29 |
| 1952928517 | De'anna Tenae Nicholas | Behavior Technician | 4624 Park St, Jacksonville, FL 32205-7327 | 2020-06-30 |
| 1083242556 | Tisha Yolanda Johnson | Behavior Technician | 4624 Park St, Jacksonville, FL 32205-7327 | 2020-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003466830 | Brandon Neil Hillard | Registered Nurse | 1260 Mcduff Ave. South, Suite 4, Jacksonville, FL 32205 | 2019-09-13 |
| 1720436363 | Ericka Sampson | Massage Therapist | 6859 Lenox Ave., Suite 6, Jacksonville, FL 32205 | 2016-05-24 |
| 1578921631 | Northstar Counseling | Counselor | 1672 Pershing Rd, Jacksonville, FL 32205 | 2016-02-04 |
| 1649645144 | Magaly Perez-cruz | Speech-Language Pathologist | 4101-1 College Street, Jacksonville, FL 32205 | 2015-12-09 |
| 1639448723 | First Choice Adult Daycare and Home Health Ca | Specialist | 5336 Quan Drive, Jacksonville, FL 32205 | 2011-12-20 |
| 1437434222 | Christopher Styer | Pharmacist | 654 Casset Ave, Jacksonville, FL 32205 | 2011-10-12 |
| 1871827279 | April Marie Felton | Nurse Practitioner | 500 E. Adams Street, Bay Street Health Center, Jacksonville, FL 32205 | 2009-10-01 |
| 1922244821 | Danielle Marie Sergent | Physical Therapist | 5222 Lenox Ave., Jacksonville, FL 32205 | 2008-12-23 |
| 1427181775 | Lapp & Associates Behavioral Counselind Ctr | Counselor | 931 Cassat Avenue, Jacksonville, FL 32205 | 2007-03-14 |
| 1629143326 | Elias Moussa Sargi | Dentist | 2700 Riverside Avenue, Ste 10, Jacksonville, FL 32205 | 2006-11-21 |
| Find all providers in zip 32205 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720691843 | Eralene Manangan | Nurse Practitioner | 4205 Belfort Rd Ste 4030, Jacksonville, FL 32216-1475 | 2020-08-28 |
| 1306456025 | Richard Mercer | Nurse Practitioner | 3545 Saint Johns Bluff Rd S Ste 137, Jacksonville, FL 32224-2682 | 2020-08-06 |
| 1467060434 | Rebecca Bertone | Nurse Practitioner | 8540 Turkey Oaks Dr S, Jacksonville, FL 32277-2920 | 2020-07-16 |
| 1861018616 | Octavia J Robertson | Nurse Practitioner | 3562 Boone Park Ave, Jacksonville, FL 32205-8433 | 2020-06-17 |
| 1902428568 | Kimberly J Grant | Nurse Practitioner | 8680 Baymeadows Rd E Apt 1413, Jacksonville, FL 32256-4002 | 2020-05-17 |
| 1447710900 | Shannska Atis | Nurse Practitioner | 580 W 8th St Fl II5, Jacksonville, FL 32209-6533 | 2019-03-21 |
| 1811462237 | Dzenefa Ramic | Nurse Practitioner | 10175 Fortune Pkwy Unit 206, Jacksonville, FL 32256-6748 | 2018-10-11 |
| 1851871024 | Shakhia Grant | Nurse Practitioner | 3636 University Blvd S Ste B, Jacksonville, FL 32216-4223 | 2018-08-17 |
| 1295230845 | Lacey Cawthron | Nurse Practitioner | 8130 Baymeadows Cir W Ste 109, Jacksonville, FL 32256-1837 | 2018-03-27 |
| 1083116107 | Kbn Healthcare, Pllc | Nurse Practitioner | 9471 Baymeadows Rd Ste 3, Jacksonville, FL 32256-7932 | 2018-03-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32205 |
Please comment or provide details below to improve the information on DANELLE WEAVER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.