Provider Demographics
NPI:1619051000
Name:WEBB, MARIANNE E (APN, RXN, PMHCNS-BC)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:E
Last Name:WEBB
Suffix:
Gender:F
Credentials:APN, RXN, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:HAXTUN
Mailing Address - State:CO
Mailing Address - Zip Code:80731-0201
Mailing Address - Country:US
Mailing Address - Phone:303-835-1545
Mailing Address - Fax:303-872-4884
Practice Address - Street 1:106 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:HAXTUN
Practice Address - State:CO
Practice Address - Zip Code:80731-2827
Practice Address - Country:US
Practice Address - Phone:303-835-1545
Practice Address - Fax:303-872-4884
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO77083364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53009053Medicaid
COP72815Medicare UPIN