Healthcare Provider Details

I. General information

NPI: 1033176508
Provider Name (Legal Business Name): BARBARA JEAN WERHANE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 PLEASANT ST
EAGLE WI
53119
US

IV. Provider business mailing address

W9546 CO RD B
CLINTON WI
53525
US

V. Phone/Fax

Practice location:
  • Phone: 262-745-7899
  • Fax:
Mailing address:
  • Phone: 262-736-9198
  • Fax: 262-736-9198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number64609030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: