Provider Demographics
NPI:1063686830
Name:WARNER, CHRISTINE LINN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LINN
Last Name:WARNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:LINN
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15590 GREENSBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:OH
Mailing Address - Zip Code:43451-9764
Mailing Address - Country:US
Mailing Address - Phone:419-722-9258
Mailing Address - Fax:
Practice Address - Street 1:15590 GREENSBURG PIKE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:OH
Practice Address - Zip Code:43451-9764
Practice Address - Country:US
Practice Address - Phone:419-722-9258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN101867164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse