Provider Demographics
NPI:1447009410
Name:WEBBER, AMY (ARNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WEBBER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 OKOBOJI AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:IA
Mailing Address - Zip Code:51351-1754
Mailing Address - Country:US
Mailing Address - Phone:712-330-5347
Mailing Address - Fax:
Practice Address - Street 1:610 OKOBOJI AVE STE 1
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:IA
Practice Address - Zip Code:51351-1754
Practice Address - Country:US
Practice Address - Phone:712-330-5347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG177325363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health