Provider Demographics
NPI:1295117133
Name:WARNER, MICHELLE ANGELA (RN, NP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANGELA
Last Name:WARNER
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 REGALWOOD TER
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-2224
Mailing Address - Country:US
Mailing Address - Phone:301-452-4360
Mailing Address - Fax:
Practice Address - Street 1:4405 REGALWOOD TER
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-2224
Practice Address - Country:US
Practice Address - Phone:301-452-4360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-27
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR143980363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health