Healthcare Provider Details

I. General information

NPI: 1245039072
Provider Name (Legal Business Name): TASHEMA WEBB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2498 PERRY CROSSING WAY STE 240 PMB 106
PLAINFIELD IN
46168
US

IV. Provider business mailing address

2498 PERRY CROSSING WAY STE 240 PMB 106
PLAINFIELD IN
46168
US

V. Phone/Fax

Practice location:
  • Phone: 317-496-9396
  • Fax:
Mailing address:
  • Phone: 317-496-9396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: