Basic Information
| Provider Information | |||||||||
| NPI: | 1356307276 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WERNER | ||||||||
| FirstName: | JANE | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1560 E. MAPLE RD. | ||||||||
| Address2: | SUITE 400 - CREDENTIALING | ||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480831135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485815977 | ||||||||
| FaxNumber: | 2485815640 | ||||||||
| Practice Location | |||||||||
| Address1: | 5333 MCAULEY DR | ||||||||
| Address2: | SUITE 4011 | ||||||||
| City: | YPSILANTI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481971014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347127550 | ||||||||
| FaxNumber: | 7347127576 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2006 | ||||||||
| LastUpdateDate: | 03/02/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 4301060291 | MI | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 7318 | 01 | MI | CAPE HEALTH PLAN | OTHER | C1230 | 01 | MI | MCARE | OTHER | 4229750 | 05 | MI | MEDICAID | P00164626 | 01 | MI | RAILROAD MEDICARE | OTHER | 103836 | 01 | MI | PREFERRED CHOICES PPO | OTHER | 103836 | 01 | MI | CARE CHOICE | OTHER | 1808129481 | 01 | MI | BCBS | OTHER |