Provider Demographics
NPI:1740479815
Name:WEBB, PAULA (SFA)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:SFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22105 LAMAR RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MO
Mailing Address - Zip Code:64098-9179
Mailing Address - Country:US
Mailing Address - Phone:816-868-5881
Mailing Address - Fax:816-450-3310
Practice Address - Street 1:22105 LAMAR RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MO
Practice Address - Zip Code:64098-9179
Practice Address - Country:US
Practice Address - Phone:816-868-5881
Practice Address - Fax:816-450-3310
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist