Provider Demographics
NPI:1073335006
Name:WEBB, MARIE M (FNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:M
Last Name:WEBB
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 MARYVILLE UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7299
Mailing Address - Country:US
Mailing Address - Phone:800-627-9855
Mailing Address - Fax:
Practice Address - Street 1:650 MARYVILLE UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7299
Practice Address - Country:US
Practice Address - Phone:800-627-9855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11036193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily