Provider Demographics
NPI:1427730316
Name:WEBBER, HANAH MAMIE (LVN)
Entity type:Individual
Prefix:MRS
First Name:HANAH
Middle Name:MAMIE
Last Name:WEBBER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9618 SOARING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-1089
Mailing Address - Country:US
Mailing Address - Phone:510-396-2092
Mailing Address - Fax:
Practice Address - Street 1:9618 SOARING OAKS DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-1089
Practice Address - Country:US
Practice Address - Phone:510-396-2092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN134236164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse