Provider Demographics
NPI:1952045361
Name:WARNOCK, AMANDA LAUREN (MPH, C-FSD(BADT))
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LAUREN
Last Name:WARNOCK
Suffix:
Gender:F
Credentials:MPH, C-FSD(BADT)
Other - Prefix:
Other - First Name:AMA
Other - Middle Name:
Other - Last Name:WARNOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPH, C-FSD(BADT)
Mailing Address - Street 1:1380 E HYDE PARK BLVD APT 507
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-2946
Mailing Address - Country:US
Mailing Address - Phone:317-379-9140
Mailing Address - Fax:
Practice Address - Street 1:1380 E HYDE PARK BLVD APT 507
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-2946
Practice Address - Country:US
Practice Address - Phone:317-379-9140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula