Healthcare Provider Details

I. General information

NPI: 1447962881
Provider Name (Legal Business Name): KEVIN B WEBSTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2022
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 TYLERSVILLE RD # D
WEST CHESTER OH
45011-8634
US

IV. Provider business mailing address

4308 TYLERSVILLE RD
WEST CHESTER OH
45011-8634
US

V. Phone/Fax

Practice location:
  • Phone: 513-325-6685
  • Fax:
Mailing address:
  • Phone: 513-325-6685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberRP187789
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: