Provider Demographics
NPI:1184058638
Name:WERNER, DELLA M (CRNP)
Entity type:Individual
Prefix:
First Name:DELLA
Middle Name:M
Last Name:WERNER
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 1:4133 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BROAD TOP
Mailing Address - State:PA
Mailing Address - Zip Code:16621-9001
Mailing Address - Country:US
Mailing Address - Phone:814-635-2916
Mailing Address - Fax:814-635-2918
Practice Address - Street 1:358 SEMINARY ST
Practice Address - Street 2:
Practice Address - City:CASSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16623-6203
Practice Address - Country:US
Practice Address - Phone:814-448-9226
Practice Address - Fax:814-448-2068
Is Sole Proprietor?:No
Enumeration Date:2013-09-01
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012993363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA357182OtherMEDICARE
PA102941695Medicaid