Healthcare Provider Details

I. General information

NPI: 1316256068
Provider Name (Legal Business Name): DOROTHY L WERE DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 10/14/2020
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 ODONNELL ST
BALTIMORE MD
21224-5269
US

IV. Provider business mailing address

1340 S DAMEN AVE STE 400
CHICAGO IL
60608-1169
US

V. Phone/Fax

Practice location:
  • Phone: 610-834-1122
  • Fax:
Mailing address:
  • Phone: 312-262-2739
  • Fax: 312-564-4059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR170382
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR170382
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: