Provider Demographics
NPI:1891193009
Name:WARNER, TANYA R (LPN)
Entity Type:Individual
Prefix:MS
First Name:TANYA
Middle Name:R
Last Name:WARNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WARBURTON AVE
Mailing Address - Street 2:4P
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1052
Mailing Address - Country:US
Mailing Address - Phone:914-720-3452
Mailing Address - Fax:
Practice Address - Street 1:1100 WARBURTON AVE
Practice Address - Street 2:4P
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1052
Practice Address - Country:US
Practice Address - Phone:914-720-3452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307133-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse