Individual
AMANDA JEAN WERNEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CRNA
Contact information
Practice address
1200 E PECAN ST, ALTUS, OK 73521-6192
(580) 379-5860
(580) 379-5859
Mailing address
1200 E PECAN ST, ALTUS, OK 73521-6192
(580) 379-5860
(580) 379-5859
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
106409
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200773860A
—
OK
Enumeration date
06/19/2018
Last updated
08/29/2022
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