Provider Demographics
NPI:1568044501
Name:WEBB, JANA MICHELLE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JANA
Middle Name:MICHELLE
Last Name:WEBB
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:MICHELLE
Other - Last Name:BUETTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2107 WESTMORE DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73170-7453
Mailing Address - Country:US
Mailing Address - Phone:405-420-5524
Mailing Address - Fax:
Practice Address - Street 1:2107 WESTMORE DR
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73170-7453
Practice Address - Country:US
Practice Address - Phone:405-420-5524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1888265364SF0001X
OK201761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health