Individual ProviderRyan Jeffrey WernerNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3600 Joseph Siewick Dr, Fairfax, VA 22033-1709(703) 391-3600(231) 349-0421PECOS EnrollmentBased on the most recent information from CMS, provider Ryan Jeffrey Werner does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1417304502Provider TypeIndividualFull NameWerner, Ryan JeffreyTitleMr.CredentialCRNAGenderMaleSole ProprietorNoEnumeration Date5/18/2016Last Updated11/22/2021Contact InformationPractice LocationPractice Address3600 Joseph Siewick Dr, Fairfax, VA 22033-1709Phone(703) 391-3600FaxUnlisted FaxMailing LocationMailing Address9016 Kiger St, Lorton, VA 22079-3103Phone(231) 349-0421FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024181578VirginiaCode367500000XDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense4704270624MichiganProvider IdentifiersIDDescriptionIssuerIDK231360DescriptionOtherIssuerMEDICAREKentuckyID300008176DescriptionMedicaidIssuerUnlistedIndiana