Provider Demographics
NPI: | 1689007031 |
---|---|
Name: | WERNER, MARION WILHOITE (FNP-C) |
Entity type: | Individual |
Prefix: | |
First Name: | MARION |
Middle Name: | WILHOITE |
Last Name: | WERNER |
Suffix: | |
Gender: | F |
Credentials: | FNP-C |
Other - Prefix: | |
Other - First Name: | MARION |
Other - Middle Name: | LEIGH |
Other - Last Name: | WILHOITE |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | |
Mailing Address - Street 1: | 9850 GENESEE AVE |
Mailing Address - Street 2: | SUITE 730 |
Mailing Address - City: | LA JOLLA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92037-1224 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 858-847-5064 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 9850 GENESEE AVE |
Practice Address - Street 2: | SUITE 730 |
Practice Address - City: | LA JOLLA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92037-1224 |
Practice Address - Country: | US |
Practice Address - Phone: | 858-847-5064 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2013-08-20 |
Last Update Date: | 2025-03-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 848707 | 163W00000X |
TN | 25255 | 207Q00000X, 363LF0000X |
CA | 23513 | 363LF0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No | 163W00000X | Nursing Service Providers | Registered Nurse | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |