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Individual
ELLEN R WEBER
Active
Individual
ELLEN R WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
C055343
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0431999
—
IA
01
—
30442
WELLMARK BCBS
IA
Enumeration date
09/22/2005
Last updated
12/19/2007
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