MEDICARE: THOMAS WEBB CNP

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	363LF0000X	Family Nurse Practitioner	APRN.CNP.0033311	OH

General Provider Information

NPI Number	:	1457050320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS WEBB CNP

Provider Business Mailing Address
First Line	:	1842 W 3RD AVE
Second Line	:
City	:	GRANDVIEW HEIGHTS
State	:	OH
Zip	:	43212-2772
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1842 W 3RD AVE
Second Line	:
City	:	GRANDVIEW HEIGHTS
State	:	OH
Zip	:	43212-2772
Country	:	US
Telephone Number	:	740-701-2434
Fax Number	:

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

Provider Enumeration Date	:	02/28/2023
Last Update Date	:	05/20/2024

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