Provider Demographics
NPI:1306008511
Name:WARNER, TERESA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIE
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 1:18205 HAZELWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-3530
Mailing Address - Country:US
Mailing Address - Phone:216-526-4139
Mailing Address - Fax:216-581-5144
Practice Address - Street 1:18205 HAZELWOOD AVE
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-3530
Practice Address - Country:US
Practice Address - Phone:216-526-4139
Practice Address - Fax:216-581-5144
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH340146163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse