Healthcare Provider Details

I. General information

NPI: 1033567474
Provider Name (Legal Business Name): JESSIE WERNER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2823 FRESNO ST
FRESNO CA
93721-1324
US

IV. Provider business mailing address

110 ELM ST
PROVIDENCE RI
02903-4626
US

V. Phone/Fax

Practice location:
  • Phone: 559-499-6440
  • Fax:
Mailing address:
  • Phone: 401-444-4000
  • Fax: 401-427-7795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD20679
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA167859
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: