Provider Demographics
NPI:1720397680
Name:WOMER, KARIANN MELISSA (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:KARIANN
Middle Name:MELISSA
Last Name:WOMER
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:KARIANN
Other - Middle Name:MELISSA
Other - Last Name:MECH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:1491 SHERIDAN DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14217
Mailing Address - Country:US
Mailing Address - Phone:716-332-4476
Mailing Address - Fax:716-447-1286
Practice Address - Street 1:1491 SHERIDAN DR STE 100
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14217-1234
Practice Address - Country:US
Practice Address - Phone:716-332-4476
Practice Address - Fax:716-447-1286
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014297363AM0700X
PAMA055389363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical