Provider Demographics
NPI:1508055450
Name:WERNER, STEPHANIE LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNN
Last Name:WERNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 RED BANKS RD STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5766
Mailing Address - Country:US
Mailing Address - Phone:252-321-3579
Mailing Address - Fax:252-321-3576
Practice Address - Street 1:504 RED BANKS RD STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5766
Practice Address - Country:US
Practice Address - Phone:252-321-3579
Practice Address - Fax:252-321-3576
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5081111N00000X
NC3944111N00000X
NYX011321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor