Provider Demographics
NPI:1851303481
Name:WERNLI, KARA B (MPT)
Entity Type:Individual
Prefix:MS
First Name:KARA
Middle Name:B
Last Name:WERNLI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 E 97TH CT APT 705
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-7372
Mailing Address - Country:US
Mailing Address - Phone:918-299-6618
Mailing Address - Fax:
Practice Address - Street 1:4004 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6017
Practice Address - Country:US
Practice Address - Phone:918-622-4278
Practice Address - Fax:918-622-4844
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00407227OtherMEDICARE RAILROAD
7972807OtherAETNA LEGACY
P00407227OtherMEDICARE RAILROAD