NPI 1528774932

Javlyn Dickson Weaver, PA

Practitioner Physician Assistant Mountain Home, ID

Practice location

Address: 895 N 6th E, Mountain Home, ID 83647-2207
Phone: (208) 587-8401
Mailing address: 780 S 2075 W, Cedar City, UT 84720-1921

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 12989329-1206 (UT)

Other Physician Assistant providers in Idaho →

Registry record

NPI: 1528774932
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jan 2023
Record last updated: 30 Jan 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.