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General NPI Number Information
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NPI Number | 1023047594
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Entity Type | Individual
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Provider Name | KATHLEEN F. WEBBER CPNP
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 3950 BEAUBIEN CHILDREN'S SPECIALTY CLINIC
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City | DETROIT
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State | MI
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Zip | 48201-2169
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Country | US
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Telephone | 202-253-9525
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Fax | 313-966-7478
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Provider Business Mailing Address
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Address Line | 34 NEWBERRY PL
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-3750
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Country | US
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Telephone | 202-253-9525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 4704271044
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License Number State | MI
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