Provider Demographics
NPI:1477077394
Name:WARNER, ANGELA MARIE (WHNP)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MARIE
Last Name:WARNER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 505633
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-5633
Mailing Address - Country:US
Mailing Address - Phone:636-936-8777
Mailing Address - Fax:636-939-4257
Practice Address - Street 1:209 FIRST EXECUTIVE AVE
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1697
Practice Address - Country:US
Practice Address - Phone:636-936-8777
Practice Address - Fax:636-939-4257
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009035544363LW0102X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420122527Medicaid