Provider Demographics
NPI:1518228600
Name:WEBBER, LEE L (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LEE
Middle Name:L
Last Name:WEBBER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 MCKINNEY AVE STE 155-814
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1413
Mailing Address - Country:US
Mailing Address - Phone:214-449-0110
Mailing Address - Fax:469-850-6803
Practice Address - Street 1:3839 MCKINNEY AVE STE 155-814
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-1413
Practice Address - Country:US
Practice Address - Phone:214-449-0110
Practice Address - Fax:469-850-6803
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.414315163W00000X
IL209.010736163WP0000X, 367500000X, 363L00000X
TX1073767367500000X
WI17336330367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner