Provider Demographics
NPI:1134188188
Name:WERKHEISER, DAISY M (CRNP)
Entity type:Individual
Prefix:MRS
First Name:DAISY
Middle Name:M
Last Name:WERKHEISER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5305
Mailing Address - Country:US
Mailing Address - Phone:410-543-6962
Mailing Address - Fax:410-548-5151
Practice Address - Street 1:300 W CARROLL ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5305
Practice Address - Country:US
Practice Address - Phone:410-543-6962
Practice Address - Fax:410-548-5151
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR071488363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD784381000Medicaid