Provider Demographics
NPI:1962478313
Name:WEBB, COLLEEN VICTORIA (CRNP, FAMLY)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:VICTORIA
Last Name:WEBB
Suffix:
Gender:F
Credentials:CRNP, FAMLY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-1474
Mailing Address - Country:US
Mailing Address - Phone:717-801-4846
Mailing Address - Fax:717-854-0377
Practice Address - Street 1:1230 HIGH ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1127
Practice Address - Country:US
Practice Address - Phone:717-632-9052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208627363LF0000X
TN145967363L00000X
VA0024170848363LF0000X
PASP017493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ57865Medicare UPIN