Healthcare Provider Details

I. General information

NPI: 1982917837
Provider Name (Legal Business Name): KRISTIN N WERKMEISTER O D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2010
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1997 BARRETT CT
HENDERSON KY
42420-2667
US

IV. Provider business mailing address

1997 BARRETT CT
HENDERSON KY
42420-2667
US

V. Phone/Fax

Practice location:
  • Phone: 270-826-9966
  • Fax: 270-827-1206
Mailing address:
  • Phone: 270-826-9966
  • Fax: 270-827-1206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1806DT
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: