Provider Demographics
NPI:1669457941
Name:WEBBER, DONNA C (APRN)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:C
Last Name:WEBBER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 MANSFIELD RD
Mailing Address - Street 2:UNIT 1255
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06269-1255
Mailing Address - Country:US
Mailing Address - Phone:860-486-4705
Mailing Address - Fax:860-486-9159
Practice Address - Street 1:377 MANSFIELD RD
Practice Address - Street 2:UNIT 1255
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06269-1255
Practice Address - Country:US
Practice Address - Phone:860-486-4705
Practice Address - Fax:860-486-9159
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2023-10-17
Deactivation Date:2023-09-26
Deactivation Code:
Reactivation Date:2023-10-17
Provider Licenses
StateLicense IDTaxonomies
CTE34122163WP0808X
CT000591163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004167096Medicaid
1158BILLJPAOtherCASE MANAGEMENT
282907OtherHORIZON
IP341658OtherMAGELLAN CTCARE
142857OtherTRICARE
241246000OtherMAGELLAN MBC
061380466OtherN
061380466OtherPLAN
175509000OtherMASSACHUSSETTES
282907OtherNETWORK INC
7260046OtherAETNA PPO
061380466OtherHEALTH
24124600OtherMAGELLAN AETNA
061380466OtherHEALTHCARE
2125052OtherCIGNA MCC
O43443956OtherHEALTH
400000591CT03OtherANTHEM BCBS
142857OtherTRICARE
175509000OtherMASSACHUSSETTES
S67054Medicare UPIN