Provider Demographics
NPI:1073281739
Name:WARRICK, INA JEAN
Entity Type:Individual
Prefix:MRS
First Name:INA
Middle Name:JEAN
Last Name:WARRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43358-9568
Mailing Address - Country:US
Mailing Address - Phone:937-935-4742
Mailing Address - Fax:
Practice Address - Street 1:221 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43358-9568
Practice Address - Country:US
Practice Address - Phone:937-935-4742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care