Individual
HEATHER KOHLI-WERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11101 CATHAGE RD, BERLIN, MD 21811
(410) 912-6104
(410) 208-1872
Mailing address
100 E CARROLL ST, SALISBURY, MD 21801-5422
(410) 543-7531
(410) 912-6386
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110003851
VA
363A00000X
Physician Assistant
1088241
OH
363A00000X
Physician Assistant
Primary
C0006714
MD
363A00000X
Physician Assistant
C5-0000888
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720319452
—
VA
Enumeration date
01/20/2010
Last updated
12/28/2018
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