Provider Demographics
NPI:1376014902
Name:WEBLEY, CHARMAINE B (NURSE PRACTITIONER)
Entity type:Individual
Prefix:DR
First Name:CHARMAINE
Middle Name:B
Last Name:WEBLEY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:CHARMAINE
Other - Middle Name:B
Other - Last Name:WEBLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:57 BILTMORE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-2613
Mailing Address - Country:US
Mailing Address - Phone:413-579-8808
Mailing Address - Fax:754-799-2825
Practice Address - Street 1:57 BILTMORE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-2613
Practice Address - Country:US
Practice Address - Phone:413-579-8808
Practice Address - Fax:754-799-2825
Is Sole Proprietor?:No
Enumeration Date:2018-12-07
Last Update Date:2025-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA269816363L00000X, 363LF0000X, 363LP0808X
CT8457363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health