Provider Demographics
NPI:1770815839
Name:WEBB, ALETHA DESIREE MARIE (ANP-BC)
Entity Type:Individual
Prefix:
First Name:ALETHA
Middle Name:DESIREE MARIE
Last Name:WEBB
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:ALETHA
Other - Middle Name:DESIREE MARIE
Other - Last Name:MATSIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:5730 BOWDEN ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216
Mailing Address - Country:US
Mailing Address - Phone:904-419-0273
Mailing Address - Fax:904-419-4981
Practice Address - Street 1:75 2ND AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2820
Practice Address - Country:US
Practice Address - Phone:800-363-4752
Practice Address - Fax:781-444-9588
Is Sole Proprietor?:No
Enumeration Date:2010-01-31
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9323571363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health