Provider Demographics
NPI:1225136393
Name:WEBLEY, JEAN H (CNM)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:H
Last Name:WEBLEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4898 SW 183RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6321
Mailing Address - Country:US
Mailing Address - Phone:954-437-0384
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI-DADE
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-585-5116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0969702363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3401391-00Medicaid
FL3401391-00Medicaid