MEDICARE: DR. JUDITH LORRAINE WEBB NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	302568	NY
2	363LA2200X	Adult Health Nurse Practitioner	RN2268102	MA

General Provider Information

NPI Number	:	1023170537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH LORRAINE WEBB NP

Provider Business Mailing Address
First Line	:	62 WEST ST
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-2228
Country	:	US
Telephone Number	:	339-224-7862
Fax Number	:

Provider Business Practice Location Address
First Line	:	62 WEST ST
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-2228
Country	:	US
Telephone Number	:	339-224-7862
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	02/23/2014

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