Provider Demographics
NPI:1306222419
Name:WEBSTER-DOWELL, LAVERN (APRN)
Entity type:Individual
Prefix:
First Name:LAVERN
Middle Name:
Last Name:WEBSTER-DOWELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LAVERN
Other - Middle Name:
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2520 UNIVERSITY BLVD W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2004
Mailing Address - Country:US
Mailing Address - Phone:904-914-8947
Mailing Address - Fax:904-895-4729
Practice Address - Street 1:2520 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2004
Practice Address - Country:US
Practice Address - Phone:904-914-8947
Practice Address - Fax:904-895-4729
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3300612363LF0000X
FLAPRN3300612363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015427400Medicaid
FLIH381ZMedicare PIN