Provider Demographics
NPI:1164429197
Name:WARNER, LEANNE CORINNE (DC)
Entity Type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:CORINNE
Last Name:WARNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 JOHNSON ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-3042
Mailing Address - Country:US
Mailing Address - Phone:612-789-1010
Mailing Address - Fax:612-789-9205
Practice Address - Street 1:2726 JOHNSON ST NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-3042
Practice Address - Country:US
Practice Address - Phone:612-789-1010
Practice Address - Fax:612-789-9205
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3C806WAOtherBLUE CROSS/BLUE SHIELD