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Individual

JACOB RYAN WEBBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
3100 SUPERIOR AVE, SHEBOYGAN, WI 53081-1948
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13592-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100231423
WI
Enumeration date
01/12/2023
Last updated
10/17/2024
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