Provider Demographics
NPI:1659010734
Name:WEBB, CORINNE BECKER (DNP FNP)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:BECKER
Last Name:WEBB
Suffix:
Gender:F
Credentials:DNP FNP
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 CAREY RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-7880
Mailing Address - Country:US
Mailing Address - Phone:518-761-0300
Mailing Address - Fax:518-824-2388
Practice Address - Street 1:2249 STATE ROUTE 86 STE 3
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-5646
Practice Address - Country:US
Practice Address - Phone:518-891-3845
Practice Address - Fax:518-891-1236
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY355417363LF0000X
VT101.0135590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07305104Medicaid