Healthcare Provider Details

I. General information

NPI: 1538072897
Provider Name (Legal Business Name): COURTNEY ANN WEBB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 9TH ST
PANA IL
62557-1716
US

IV. Provider business mailing address

718 N SNODGRASS ST
TAYLORVILLE IL
62568-1650
US

V. Phone/Fax

Practice location:
  • Phone: 217-562-2544
  • Fax:
Mailing address:
  • Phone: 217-827-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209036609041505701
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: