Provider Demographics
NPI:1386486330
Name:WERNER, KEIRA ERIN (APN)
Entity type:Individual
Prefix:
First Name:KEIRA
Middle Name:ERIN
Last Name:WERNER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017
Mailing Address - Country:US
Mailing Address - Phone:973-672-8573
Mailing Address - Fax:
Practice Address - Street 1:613 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017
Practice Address - Country:US
Practice Address - Phone:866-525-9018
Practice Address - Fax:888-412-1759
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15029800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health