Provider Demographics
NPI:1679532139
Name:WEBB, ANN MICHELLE (CFNP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MICHELLE
Last Name:WEBB
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-2949
Mailing Address - Country:US
Mailing Address - Phone:219-866-1890
Mailing Address - Fax:
Practice Address - Street 1:123 S MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-2949
Practice Address - Country:US
Practice Address - Phone:219-866-1890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001896A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200532880Medicaid
IN000000372084OtherANTHEM PROVIDER NUMBER
IN9397732OtherPHCS PID NUMBER
IN142090WMedicare PIN
IN069330OMedicare PIN
IN9397732OtherPHCS PID NUMBER
IN000000372084OtherANTHEM PROVIDER NUMBER
IN921480KKMedicare PIN