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NPI Code Detail

MEDICARE: KELSEY WERNER

MEDICARE: KELSEY WERNER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist28878NC

General Provider Information

NPI Number : 1295385375
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY WERNER
Provider Business Mailing Address
First Line : 144 4TH STREET
Second Line : UNIT 107
City : BURLINGTON
State : NC
Zip : 27215
Country : US
Telephone Number : 704-942-5632
Fax Number :
Provider Business Practice Location Address
First Line : 1615 SPRING GARDEN ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-2334
Country : US
Telephone Number : 336-379-1649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2019
Last Update Date : 09/19/2019

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Directions to “ KELSEY WERNER ” Practice Location

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