Basic Information
| Provider Information | |||||||||
| NPI: | 1841328697 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WERNER | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | ASHTON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 S WILKES BARRE BLVD | ||||||||
| Address2: | GEISINGER KISTLER CLINIC | ||||||||
| City: | WILKES BARRE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187025040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708292621 | ||||||||
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| Practice Location | |||||||||
| Address1: | 123 EAST MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | NANTICOKE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702581304 | ||||||||
| FaxNumber: | 5705281305 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2007 | ||||||||
| LastUpdateDate: | 07/31/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 27290 | SC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 435373 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.