Provider Demographics
NPI:1164932216
Name:WEBB, ELIZABETH LARSEN (CRNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LARSEN
Last Name:WEBB
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 MAPLE RIDGE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35757-6338
Mailing Address - Country:US
Mailing Address - Phone:256-508-2920
Mailing Address - Fax:
Practice Address - Street 1:44 HUGHES RD STE 2350
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3048
Practice Address - Country:US
Practice Address - Phone:256-464-8822
Practice Address - Fax:256-464-9988
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-146916363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health