Healthcare Provider Details

I. General information

NPI: 1033342506
Provider Name (Legal Business Name): VALARIE IRENE WEBB N.P.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 E OAK ST
MC RAE HELENA GA
31055-4338
US

IV. Provider business mailing address

144 E OAK ST
MC RAE GA
31055-4338
US

V. Phone/Fax

Practice location:
  • Phone: 229-868-7342
  • Fax: 229-868-4344
Mailing address:
  • Phone: 229-868-7342
  • Fax: 229-868-4344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN118538
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1164075347
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerBUSINESS NPI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: