Provider Demographics
NPI:1487270542
Name:WEBB, THANA A (RN)
Entity type:Individual
Prefix:
First Name:THANA
Middle Name:A
Last Name:WEBB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:HAPPY CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:96039-1016
Mailing Address - Country:US
Mailing Address - Phone:530-493-1600
Mailing Address - Fax:530-493-1648
Practice Address - Street 1:1519 S OREGON ST
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3425
Practice Address - Country:US
Practice Address - Phone:530-842-9200
Practice Address - Fax:530-842-9207
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA-RN-25648163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse