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General NPI Number Information
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NPI Number | 1861175242
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Entity Type | Individual
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Provider Name | ALISSA LOUISE WEBER DNP, AGAC-NP
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Gender | Female
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 515 22ND AVE
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City | MONROE
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State | WI
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Zip | 53566-1569
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Country | US
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Telephone | 608-324-2453
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 ANN MARIE WAY
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City | OCONOMOWOC
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State | WI
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Zip | 53066-2916
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Country | US
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Telephone | 859-519-8571
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 14149-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 14149-33
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 237698-30
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License Number State | WI
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