Healthcare Provider Details

I. General information

NPI: 1073335006
Provider Name (Legal Business Name): MARIE M WEBB FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 MARYVILLE UNIVERSITY DR
CREVE COEUR MO
63141-7299
US

IV. Provider business mailing address

650 MARYVILLE UNIVERSITY DR
CREVE COEUR MO
63141-7299
US

V. Phone/Fax

Practice location:
  • Phone: 800-627-9855
  • Fax:
Mailing address:
  • Phone: 800-627-9855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11036193
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: