Provider Demographics
NPI:1821355025
Name:WARRINER, LLC
Entity Type:Organization
Organization Name:WARRINER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WARRINER
Authorized Official - Suffix:
Authorized Official - Credentials:FPNP-BC
Authorized Official - Phone:719-440-0126
Mailing Address - Street 1:1301 S 8TH ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-7335
Mailing Address - Country:US
Mailing Address - Phone:719-440-0126
Mailing Address - Fax:719-632-4078
Practice Address - Street 1:1301 S 8TH ST
Practice Address - Street 2:SUITE 109
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-7335
Practice Address - Country:US
Practice Address - Phone:719-440-0126
Practice Address - Fax:719-632-4078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO119357363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1124168265OtherINDIVIDUAL NPI