Provider Demographics
NPI:1114251139
Name:WARNER, ALISHA LEWISE (CENA/HOME HEALTH AID)
Entity Type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:LEWISE
Last Name:WARNER
Suffix:
Gender:F
Credentials:CENA/HOME HEALTH AID
Other - Prefix:MRS
Other - First Name:ALISHA
Other - Middle Name:LEWISE
Other - Last Name:HOFMEISTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CENA/HOME HEALTH AID
Mailing Address - Street 1:155 S. TRENT RD.
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:MI
Mailing Address - Zip Code:49451
Mailing Address - Country:US
Mailing Address - Phone:616-477-5007
Mailing Address - Fax:
Practice Address - Street 1:155 S. TRENT RD.
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:MI
Practice Address - Zip Code:49451
Practice Address - Country:US
Practice Address - Phone:616-477-5007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI230014474931208376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide