Provider Demographics
NPI:1891934543
Name:WEBBER, PAMELA JOY (FNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JOY
Last Name:WEBBER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:JOY
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:N10758 CANNONBALL CT.
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:MI
Mailing Address - Zip Code:49911-9696
Mailing Address - Country:US
Mailing Address - Phone:906-663-6970
Mailing Address - Fax:
Practice Address - Street 1:N10356 SUNSET VIEW ST
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:MI
Practice Address - Zip Code:49911-9651
Practice Address - Country:US
Practice Address - Phone:906-663-6970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704208006163WG0000X, 363LF0000X
WI12560130163WG0000X
WI1179033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice