Provider Demographics
NPI:1962377135
Name:WARNE, KELLY MARIE
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:MARIE
Last Name:WARNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 PEG CT
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:DE
Mailing Address - Zip Code:19943-6616
Mailing Address - Country:US
Mailing Address - Phone:302-698-8400
Mailing Address - Fax:
Practice Address - Street 1:109 E CAMDEN WYOMING AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-1208
Practice Address - Country:US
Practice Address - Phone:302-698-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0070464163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse