Provider Demographics
NPI:1861692493
Name:WEBB, PADONDA BOYD (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:PADONDA
Middle Name:BOYD
Last Name:WEBB
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:DR
Other - First Name:PADONDA
Other - Middle Name:BOYD
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP
Mailing Address - Street 1:3803 ROBERT PORCHER WAY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2191
Mailing Address - Country:US
Mailing Address - Phone:336-286-3442
Mailing Address - Fax:336-286-1156
Practice Address - Street 1:3803 ROBERT PORCHER WAY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2191
Practice Address - Country:US
Practice Address - Phone:336-286-3442
Practice Address - Fax:336-286-1156
Is Sole Proprietor?:No
Enumeration Date:2007-07-22
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003251363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7000842Medicaid
NC7000842Medicaid