Provider Demographics
NPI:1700665312
Name:WARNER, SANDRA RENEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:RENEE
Last Name:WARNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:RENEE
Other - Last Name:WELSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3717 ROLLING MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:WI
Mailing Address - Zip Code:54155-9097
Mailing Address - Country:US
Mailing Address - Phone:414-405-1531
Mailing Address - Fax:
Practice Address - Street 1:3717 ROLLING MEADOWS RD
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:WI
Practice Address - Zip Code:54155-9097
Practice Address - Country:US
Practice Address - Phone:414-405-1531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI139736-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse