Basic Information
| Provider Information | |||||||||
| NPI: | 1851303481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WERNLI | ||||||||
| FirstName: | KARA | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2918 E 97TH CT APT 705 | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741377372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182996618 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4004 S YALE AVE | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741356017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9186224278 | ||||||||
| FaxNumber: | 9186224844 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2006 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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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 | 225100000X | 3912 | OK | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | P00407227 | 01 | MEDICARE RAILROAD | OTHER | 7972807 | 01 | AETNA LEGACY | OTHER |