Provider Demographics
NPI:1376162263
Name:KATHRYN WERNER, PA-C LLC
Entity Type:Organization
Organization Name:KATHRYN WERNER, PA-C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:731-437-1993
Mailing Address - Street 1:2008 WYNFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-7157
Mailing Address - Country:US
Mailing Address - Phone:731-437-1993
Mailing Address - Fax:
Practice Address - Street 1:2008 WYNFIELD DR
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-7157
Practice Address - Country:US
Practice Address - Phone:731-437-1993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KATHRYN WERNER, PA-C LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty