Provider Demographics
NPI:1033616552
Name:WEBB, PHELAN G (NBC-HIS)
Entity Type:Individual
Prefix:
First Name:PHELAN
Middle Name:G
Last Name:WEBB
Suffix:
Gender:F
Credentials:NBC-HIS
Other - Prefix:
Other - First Name:PHELAN
Other - Middle Name:
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NBC-HIS
Mailing Address - Street 1:3947 GULF SHORES PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-2862
Mailing Address - Country:US
Mailing Address - Phone:251-210-3929
Mailing Address - Fax:
Practice Address - Street 1:3947 GULF SHORES PKWY STE 250
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-2862
Practice Address - Country:US
Practice Address - Phone:251-210-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4088225500000X, 374700000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistGroup - Single Specialty
No374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1033616552OtherNPI