Provider Demographics
NPI:1083897698
Name:WARNER, REBECCA KOREN (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:KOREN
Last Name:WARNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 S SHERMAN ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4468
Mailing Address - Country:US
Mailing Address - Phone:720-570-0806
Mailing Address - Fax:
Practice Address - Street 1:1055 CLERMONT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3808
Practice Address - Country:US
Practice Address - Phone:303-399-8020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO174389163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse