MEDICARE: JENNIFER LYNN WEBB AGNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	905008	MS
2	363LG0600X	Gerontology Nurse Practitioner	905008	MS
3	363L00000X	Nurse Practitioner	905008	MS

General Provider Information

NPI Number	:	1003694647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN WEBB AGNP

Provider Business Mailing Address
First Line	:	329 JEFFERY ACRES RD
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39301-9134
Country	:	US
Telephone Number	:	601-527-6584
Fax Number	:

Provider Business Practice Location Address
First Line	:	329 JEFFERY ACRES RD
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39301-9134
Country	:	US
Telephone Number	:	601-527-6584
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2023
Last Update Date	:	03/24/2026

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