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General NPI Number Information
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NPI Number | 1396158879
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Entity Type | Individual
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Provider Name | JENNIFER RENEE WEBB LPN
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Gender | Female
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 420 RUDER ST
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City | WAUSAU
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State | WI
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Zip | 54403-6603
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Country | US
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Telephone | 251-223-2489
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Fax |
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Provider Business Mailing Address
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Address Line | 420 RUDER ST
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City | WAUSAU
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State | WI
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Zip | 54403-6603
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Country | US
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Telephone | 251-223-2489
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 318223
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 073197
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License Number State | MN
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