Healthcare Provider Details

I. General information

NPI: 1609979178
Provider Name (Legal Business Name): ANN WERNER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 03/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 BROCKMAN MCCLIMON RD
GREER SC
29651-6608
US

IV. Provider business mailing address

209 PLEASANTWATER CT
TAYLORS SC
29687-6163
US

V. Phone/Fax

Practice location:
  • Phone: 864-989-1432
  • Fax: 864-989-1462
Mailing address:
  • Phone: 630-730-6047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20019
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: