Provider Demographics
NPI:1073807384
Name:WEBB, LADONNA MARIE (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:LADONNA
Middle Name:MARIE
Last Name:WEBB
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 E WALNUT LAWN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7506
Mailing Address - Country:US
Mailing Address - Phone:417-269-3904
Mailing Address - Fax:417-269-8260
Practice Address - Street 1:960 E WALNUT LAWN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7506
Practice Address - Country:US
Practice Address - Phone:417-269-3904
Practice Address - Fax:417-269-8260
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004029834133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered