Provider Demographics
NPI:1457818379
Name:WARNER, SEASONS (CPM, LDEM)
Entity Type:Individual
Prefix:
First Name:SEASONS
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:CPM, LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 W 600 S
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-2707
Mailing Address - Country:US
Mailing Address - Phone:801-836-5410
Mailing Address - Fax:801-335-8252
Practice Address - Street 1:448 W 600 S
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2707
Practice Address - Country:US
Practice Address - Phone:801-836-5410
Practice Address - Fax:801-335-8252
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11080961-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife