MEDICARE: WHITNEY M WEBER DNP, CPNP-PC

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	10443-33	WI
2	363LP0200X	Pediatric Nurse Practitioner	10443-33	WI
3	363LP0200X	Pediatric Nurse Practitioner	CP002687	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316544638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY M WEBER DNP, CPNP-PC

Provider Business Mailing Address
First Line	:	1600 S HIGHLINE AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57110-1007
Country	:	US
Telephone Number	:	608-322-2925
Fax Number	:	605-322-2926

Provider Business Practice Location Address
First Line	:	1600 S HIGHLINE AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57110-1007
Country	:	US
Telephone Number	:	608-322-2925
Fax Number	:	605-322-2926

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

Provider Enumeration Date	:	10/09/2020
Last Update Date	:	08/21/2023

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