MEDICARE: KARA 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
1	101YP2500X	Professional Counselor	5723	TN

General Provider Information

NPI Number	:	1730860172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARA WERNER

Provider Business Mailing Address
First Line	:	701 PROFESSIONAL PLAZA DR STE 1
Second Line	:
City	:	GREENEVILLE
State	:	TN
Zip	:	37745-5102
Country	:	US
Telephone Number	:	423-930-9112
Fax Number	:	423-588-5904

Provider Business Practice Location Address
First Line	:	701 PROFESSIONAL PLAZA DR STE 1
Second Line	:
City	:	GREENEVILLE
State	:	TN
Zip	:	37745-5102
Country	:	US
Telephone Number	:	423-930-9112
Fax Number	:	423-588-5904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2023
Last Update Date	:	07/28/2023

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