Provider Demographics
NPI:1306224126
Name:WEBER, TRICIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 KENDALL CT
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:373 MERIDIAN PARKE LN
Practice Address - Street 2:SUITE C1
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-9420
Practice Address - Country:US
Practice Address - Phone:317-882-0295
Practice Address - Fax:317-882-3123
Is Sole Proprietor?:No
Enumeration Date:2015-05-13
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28174249A363LP0200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics