Healthcare Provider Details

I. General information

NPI: 1407927700
Provider Name (Legal Business Name): NANCY YVONNE WEBB SOCIAL WORKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 06/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1467 LAUREL WAY
ATLANTIC BEACH FL
32233-1836
US

IV. Provider business mailing address

6261 DUPONT CIRCLE CT E
JACKSONVILLE FL
32217-2567
US

V. Phone/Fax

Practice location:
  • Phone: 904-246-4042
  • Fax: 904-246-4042
Mailing address:
  • Phone: 904-448-1933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW4469
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: