Provider Demographics
NPI:1912241316
Name:WARNER, PENNY (RN)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 S CAULDER WAY
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6239
Mailing Address - Country:US
Mailing Address - Phone:281-723-3924
Mailing Address - Fax:
Practice Address - Street 1:9006 FOREST XING
Practice Address - Street 2:SUITE B
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-1185
Practice Address - Country:US
Practice Address - Phone:281-362-5237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX613434174400000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health