Provider Demographics
NPI:1023047594
Name:WEBBER, KATHLEEN F (CPNP)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:F
Last Name:WEBBER
Suffix:
Gender:F
Credentials:CPNP
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Mailing Address - Street 1:34 NEWBERRY PL
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3750
Mailing Address - Country:US
Mailing Address - Phone:202-253-9525
Mailing Address - Fax:
Practice Address - Street 1:3950 BEAUBIEN
Practice Address - Street 2:CHILDREN'S SPECIALTY CLINIC
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2169
Practice Address - Country:US
Practice Address - Phone:202-253-9525
Practice Address - Fax:313-966-7478
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704271044363LP0200X
DCRN968157363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics