Provider Demographics
NPI:1366772345
Name:WERNER, RHONDA ROELL (APNP)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ROELL
Last Name:WERNER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1997
Mailing Address - Street 2:C540
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201-1997
Mailing Address - Country:US
Mailing Address - Phone:414-337-7531
Mailing Address - Fax:414-337-3466
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-337-7531
Practice Address - Fax:414-337-3466
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3866-33364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1366772345Medicaid