MEDICARE: DANIELLE MARIE WERGE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1437607793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MARIE WERGE PA-C

Provider Business Mailing Address
First Line	:	2960 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1912
Country	:	US
Telephone Number	:	520-325-5701
Fax Number	:	520-325-0128

Provider Business Practice Location Address
First Line	:	2960 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1912
Country	:	US
Telephone Number	:	520-325-5701
Fax Number	:	520-325-0128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	12/21/2023

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