Provider Demographics
NPI:1790380806
Name:WERNE, MARCELINA B
Entity Type:Individual
Prefix:MRS
First Name:MARCELINA
Middle Name:B
Last Name:WERNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARCY
Other - Middle Name:
Other - Last Name:WERNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:5114 S SAN PAULO AVE
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85650-9353
Mailing Address - Country:US
Mailing Address - Phone:520-559-3339
Mailing Address - Fax:
Practice Address - Street 1:4041 S MCCLINTOCK DR STE 302
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5879
Practice Address - Country:US
Practice Address - Phone:520-233-7111
Practice Address - Fax:602-357-4604
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN079953163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health