Individual
MR. DEREK BRICE WEBBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACNPC-AG, MSN
Contact information
Practice address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(779) 696-6102
Mailing address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(815) 520-3698
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209.028357
IL
Other
Enumeration date
09/27/2023
Last updated
10/21/2023
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