Provider Demographics
NPI:1194296616
Name:WEBB, JEHNNIE RUTH
Entity type:Individual
Prefix:
First Name:JEHNNIE
Middle Name:RUTH
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:02 PRIVATE ROAD 5012
Mailing Address - Street 2:
Mailing Address - City:COMO
Mailing Address - State:MS
Mailing Address - Zip Code:38619
Mailing Address - Country:US
Mailing Address - Phone:662-703-8634
Mailing Address - Fax:
Practice Address - Street 1:02 PRIVATE ROAD 5012
Practice Address - Street 2:
Practice Address - City:COMO
Practice Address - State:MS
Practice Address - Zip Code:38619
Practice Address - Country:US
Practice Address - Phone:662-703-8634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care