Provider Demographics
NPI:1437765005
Name:WESNER, KARA BREANNE
Entity Type:Individual
Prefix:MISS
First Name:KARA
Middle Name:BREANNE
Last Name:WESNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SUNSHINE CIR APT 24
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-2103
Mailing Address - Country:US
Mailing Address - Phone:920-312-4623
Mailing Address - Fax:
Practice Address - Street 1:518 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2829
Practice Address - Country:US
Practice Address - Phone:920-312-4623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-19
Last Update Date:2020-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant