Provider Demographics
NPI:1326585738
Name:WARREN, CAPRISHA
Entity Type:Individual
Prefix:
First Name:CAPRISHA
Middle Name:
Last Name:WARREN
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 1:125 TOWNPARK DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-5803
Mailing Address - Country:US
Mailing Address - Phone:404-474-8777
Mailing Address - Fax:
Practice Address - Street 1:126 ENTERPRISE PATH STE 102
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2655
Practice Address - Country:US
Practice Address - Phone:470-305-1490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care