Look up the most recent NPI and PECOS records

Kelly Jo Werner

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678

PECOS Enrollment

This provider is enrolled in PECOS as KELLY WERNER.

Based on the most recent information from CMS, provider Kelly Jo Werner is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1528024692
Provider Type
Individual
Full Name
Werner, Kelly Jo
Title
Ms.
Credential
CPNP

Gender
Female
Sole Proprietor
No
Enumeration Date
4/26/2006
Last Updated
7/8/2007

Contact Information

Practice Location

2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678

(919) 786-5001

(919) 786-5051

Mailing Location

2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678

(919) 786-5001

(919) 786-5051

Provider Taxonomies

Code	Description	License
Code 363LP0200X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 005000606 North Carolina

Provider Identifiers

ID	Description	Issuer
ID 005000606	Description Other	Issuer LICENSE North Carolina

Kelly Jo Werner

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Silva, Hermes Yanuel

Watzich, Lauren Michelle

Scofield, Amy Lynn

Gilmore, Katherine Ann

Record, Elisabeth

Clasen, Kathleen F

Lewis, Carrie L

Mullins, Jennifer

Gonzales, Maureen F

Jones, Keli Smith