Provider Demographics
NPI:1912379785
Name:WERNER, STEPHANIE (APNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WERNER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 COMMUNITY CENTER DR
Mailing Address - Street 2:#202
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476-4139
Mailing Address - Country:US
Mailing Address - Phone:715-241-5404
Mailing Address - Fax:
Practice Address - Street 1:4005 COMMUNITY CENTER DR
Practice Address - Street 2:#202
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-4139
Practice Address - Country:US
Practice Address - Phone:715-241-5404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6692 - 33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily