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General NPI Number Information
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NPI Number | 1730734922
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Entity Type | Individual
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Provider Name | MS. KATHERINE SARA WERNER
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Gender | Female
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 13965 N 75TH AVE
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City | PEORIA
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State | AZ
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Zip | 85381-6097
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Country | US
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Telephone | 602-843-2991
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 N 9TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85007-1507
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Country | US
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Telephone | 602-301-5338
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 7552
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License Number State | AZ
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