Provider Demographics
NPI:1013010172
Name:WEBB, MARJORIE G (CNP)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:G
Last Name:WEBB
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:G
Other - Last Name:MOHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:3197 HIGHWAY 29
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:WI
Mailing Address - Zip Code:54027
Mailing Address - Country:US
Mailing Address - Phone:715-772-4855
Mailing Address - Fax:
Practice Address - Street 1:225 SMITH AVE N STE 400
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2534
Practice Address - Country:US
Practice Address - Phone:651-292-0616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR127314-0363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP36887Medicare UPIN