Provider Demographics
NPI:1417122474
Name:WERNER, LISA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:WERNER
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 1:4751 RUBY LN
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-1164
Mailing Address - Country:US
Mailing Address - Phone:330-273-5028
Mailing Address - Fax:
Practice Address - Street 1:4751 RUBY LN
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-1164
Practice Address - Country:US
Practice Address - Phone:330-273-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN201099163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse