Provider Demographics
NPI:1508915133
Name:WERNET, AMY LYNN (LVN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:WERNET
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:SEITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:2106 TOMAHAWK DR
Mailing Address - Street 2:
Mailing Address - City:PRT HUENEME
Mailing Address - State:CA
Mailing Address - Zip Code:93041-4285
Mailing Address - Country:US
Mailing Address - Phone:805-488-2194
Mailing Address - Fax:
Practice Address - Street 1:5700 RALSTON ST
Practice Address - Street 2:STE 312
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6050
Practice Address - Country:US
Practice Address - Phone:805-642-7033
Practice Address - Fax:805-642-7732
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN223711164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse