Basic Information
| Provider Information | |||||||||
| NPI: | 1295497246 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEBBER | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | LYNNETTE | ||||||||
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| Credential: | APRN- C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1017 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | LA CYGNE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660409102 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1017 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | LA CYGNE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660409102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137574575 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2021 | ||||||||
| LastUpdateDate: | 10/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | 79807 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | 363LF0000X | 79807 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.