MEDICARE: MARVA WEBB

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	376K00000X	Nurse's Aide	CNA35853	FL

General Provider Information

NPI Number	:	1861512345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARVA WEBB

Provider Business Mailing Address
First Line	:	PO BOX 8567
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34985-8567
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2027 BROWARD AVE
Second Line	:	APT 2
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-6039
Country	:	US
Telephone Number	:	772-359-8818
Fax Number	:

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	07/08/2007

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Directions to “ MARVA WEBB ” Practice Location

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