Provider Demographics
NPI:1790407542
Name:WARNER, EMILY (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-9454
Mailing Address - Country:US
Mailing Address - Phone:802-522-4816
Mailing Address - Fax:
Practice Address - Street 1:230 PERKINS RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-9454
Practice Address - Country:US
Practice Address - Phone:802-522-4816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTL-306352163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant