Basic Information
Provider Information
NPI: 1518309954
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VON WERNE
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: PO BOX 743144
Address2:  
City: ATLANTA
State: GA
PostalCode: 303743144
CountryCode: US
TelephoneNumber: 7865962000
FaxNumber: 3052797778
Practice Location
Address1: 8900 N KENDALL DR
Address2:  
City: MIAMI
State: FL
PostalCode: 33176
CountryCode: US
TelephoneNumber: 7865962000
FaxNumber: 3052797778
Other Information
ProviderEnumerationDate: 07/26/2013
LastUpdateDate: 02/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 01/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XARNP9204678FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000XAPRN9204678FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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