Provider Demographics
NPI:1831790872
Name:WERNER, SHARON LYNN
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:WERNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6792 KEENELAND WAY
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-3420
Mailing Address - Country:US
Mailing Address - Phone:513-573-0488
Mailing Address - Fax:513-573-0488
Practice Address - Street 1:6792 KEENELAND WAY
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3420
Practice Address - Country:US
Practice Address - Phone:513-773-6936
Practice Address - Fax:513-573-0488
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0346837Medicaid