Individual
MS. KELLY JO WERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2406 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6678
(919) 786-5001
(919) 786-5051
Mailing address
2406 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6678
(919) 786-5001
(919) 786-5051
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
005000606
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005000606
LICENSE
NC
Enumeration date
04/26/2006
Last updated
07/08/2007
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