Provider Demographics
NPI:1043063803
Name:WERKHEISER, ANNE E
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:WERKHEISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 DALE DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-4538
Mailing Address - Country:US
Mailing Address - Phone:610-568-6817
Mailing Address - Fax:
Practice Address - Street 1:140 DECATUR ST SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3204
Practice Address - Country:US
Practice Address - Phone:404-413-6229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program