Provider Demographics
NPI:1730403585
Name:WERNER, JANELLE LEIGH (PA-C)
Entity type:Individual
Prefix:MISS
First Name:JANELLE
Middle Name:LEIGH
Last Name:WERNER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:800 SPRUCE STREET
Mailing Address - Street 2:1 CATHCART
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6130
Mailing Address - Country:US
Mailing Address - Phone:215-662-3340
Mailing Address - Fax:215-349-5890
Practice Address - Street 1:800 SPRUCE STREET
Practice Address - Street 2:1 CATHCART
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6130
Practice Address - Country:US
Practice Address - Phone:215-662-3340
Practice Address - Fax:215-349-5890
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA062243363AS0400X
DCPA030661363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT363AS0400XMedicaid