Provider Demographics
NPI:1669457941
Name:WEBBER, DONNA C (APRN)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:C
Last Name:WEBBER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-3226
Mailing Address - Country:US
Mailing Address - Phone:860-550-0487
Mailing Address - Fax:
Practice Address - Street 1:16 N ELM ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-3226
Practice Address - Country:US
Practice Address - Phone:860-550-0487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2025-01-14
Deactivation Date:2023-09-26
Deactivation Code:
Reactivation Date:2023-10-17
Provider Licenses
StateLicense IDTaxonomies
CTE34122163WP0808X
CT000591163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
061380466OtherPLAN
142857OtherTRICARE
7260046OtherAETNA PPO
IP341658OtherMAGELLAN CTCARE
O43443956OtherHEALTH
061380466OtherN
1158BILLJPAOtherCASE MANAGEMENT
2125052OtherCIGNA MCC
282907OtherNETWORK INC
241246000OtherMAGELLAN MBC
282907OtherHORIZON
400000591CT03OtherANTHEM BCBS
CT004167096Medicaid
061380466OtherHEALTH
175509000OtherMASSACHUSSETTES
061380466OtherHEALTHCARE
24124600OtherMAGELLAN AETNA
142857OtherTRICARE
175509000OtherMASSACHUSSETTES
S67054Medicare UPIN