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Individual

TAMI L WERNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
200 EAST PACK, MOUNDRIDGE, KS 67107
(620) 345-6322
(620) 345-3038
Mailing address
200 EAST PACK, MOUNDRIDGE, KS 67107-0640
(620) 345-6322
(620) 345-3038

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1500639
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
042433
BLUE CROSS/BLUE SHIELD
KS
05
1001352320A
KS
01
13960
PREFERRED HEALTH SYSTEMS
KS
05
460687
KS
Enumeration date
06/16/2005
Last updated
07/09/2007
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