MEDICARE: RACHELLE ELAINE WEBB FNP-BC

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	163W00000X	Registered Nurse	422850	OH
2	363L00000X	Nurse Practitioner	0032332	OH
3	363LF0000X	Family Nurse Practitioner	APRN.CNP.0032332	OH
4	363LF0000X	Family Nurse Practitioner	4002263	KY

General Provider Information

NPI Number	:	1114165065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELLE ELAINE WEBB FNP-BC

Provider Business Mailing Address
First Line	:	90 JACKSON PIKE
Second Line	:
City	:	GALLIPOLIS
State	:	OH
Zip	:	45631-1562
Country	:	US
Telephone Number	:	740-446-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1180 SAINT CHRISTOPHER DR STE 1
Second Line	:
City	:	ASHLAND
State	:	KY
Zip	:	41101-7055
Country	:	US
Telephone Number	:	606-833-6397
Fax Number	:	606-833-6398

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

Provider Enumeration Date	:	01/30/2009
Last Update Date	:	08/16/2023

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