Provider Demographics
NPI:1881888980
Name:WEBB, JONNA GAIL (PA-C)
Entity type:Individual
Prefix:
First Name:JONNA
Middle Name:GAIL
Last Name:WEBB
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-2760
Mailing Address - Country:US
Mailing Address - Phone:479-968-8940
Mailing Address - Fax:479-968-8901
Practice Address - Street 1:2210 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-2760
Practice Address - Country:US
Practice Address - Phone:479-747-0138
Practice Address - Fax:479-968-8901
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARGL-015363A00000X
ARPA318363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant