Provider Demographics
NPI:1306552575
Name:WEBB, BRIANNA RACHEL (FNP-BC)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:RACHEL
Last Name:WEBB
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-3050
Mailing Address - Country:US
Mailing Address - Phone:573-348-8399
Mailing Address - Fax:
Practice Address - Street 1:156 MISSOURI BLVD
Practice Address - Street 2:
Practice Address - City:GRAVOIS MILLS
Practice Address - State:MO
Practice Address - Zip Code:65037-5394
Practice Address - Country:US
Practice Address - Phone:573-374-5263
Practice Address - Fax:573-374-4933
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022036190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily