Provider Demographics
NPI:1336671205
Name:WERMAN, CHRISTINA ROSE (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROSE
Last Name:WERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:ROSE
Other - Last Name:FREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1687 WOODLANE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3046
Mailing Address - Country:US
Mailing Address - Phone:651-600-3035
Mailing Address - Fax:
Practice Address - Street 1:1687 WOODLANE DR STE 101
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3046
Practice Address - Country:US
Practice Address - Phone:651-600-3035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN64207207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty