Provider Demographics
NPI:1427383900
Name:WARREN, TAQUINA MIRANDA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAQUINA
Middle Name:MIRANDA
Last Name:WARREN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TAQUINA
Other - Middle Name:MIRANDA
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2 BERRYMAN CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1649
Mailing Address - Country:US
Mailing Address - Phone:302-376-0437
Mailing Address - Fax:
Practice Address - Street 1:117 E GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1424
Practice Address - Country:US
Practice Address - Phone:302-471-3046
Practice Address - Fax:302-508-2275
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
DEA1-0003519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No171400000XOther Service ProvidersHealth & Wellness Coach