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General NPI Number Information
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NPI Number | 1356900351
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Entity Type | Individual
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Provider Name | AUTUMN WEBB
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Gender | Female
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 100 SYCAMORE DR
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City | WEST GROVE
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State | PA
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Zip | 19390-9480
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Country | US
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Telephone | 610-869-9127
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Fax |
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Provider Business Mailing Address
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Address Line | 6 BROOK LAWN DR
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City | LONG VALLEY
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State | NJ
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Zip | 07853-3225
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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