Healthcare Provider Details

I. General information

NPI: 1902501174
Provider Name (Legal Business Name): JANDEN C WEBER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 S PLUMMER AVE
CHANUTE KS
66720-1950
US

IV. Provider business mailing address

320 1/2 E MAIN ST APT A
CHANUTE KS
66720-1845
US

V. Phone/Fax

Practice location:
  • Phone: 620-431-2500
  • Fax: 620-431-1876
Mailing address:
  • Phone: 785-236-0823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2024020453
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-82773-051
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: