Provider Demographics
NPI:1306410410
Name:WERNER, MAKENZIE RENEA (NP)
Entity type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:RENEA
Last Name:WERNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MAKENZIE
Other - Middle Name:RENEA
Other - Last Name:GETTINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1300 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1198
Mailing Address - Country:US
Mailing Address - Phone:765-932-4111
Mailing Address - Fax:765-932-7505
Practice Address - Street 1:323 CONRAD HARCOURT WAY
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1161
Practice Address - Country:US
Practice Address - Phone:765-932-7081
Practice Address - Fax:765-932-7582
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011560A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily