Healthcare Provider Details

I. General information

NPI: 1376103010
Provider Name (Legal Business Name): JESSICA WALKER WEBB FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2019
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 TATE BLVD SE STE 201
HICKORY NC
28602
US

IV. Provider business mailing address

PO BOX 38
HICKORY NC
28603-0038
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-4140
  • Fax: 828-322-3767
Mailing address:
  • Phone: 828-322-4140
  • Fax: 828-322-3767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number203881
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5012559
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: