Doctor Name: | EILEEN WARNER |
NPI Number: | 1205884244 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 105257 |
Business Practice Address: | 2646 State Route 76 Willow Springs, MO - 657938254 |
Business Phone Number: | 4174695124 |
Business Fax Number: | 4174691165 |
Mailing Address: | 2646 State Route 76, WILLOW SPRINGS |
State: | MO |
Postal Code: | 657938254 |
Phone Number: | 4174695124 |
Fax Number: | 4174691165 |
NPI Enumeration Date: | 05/04/2006 |
NPI Last Update Date: | 08/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 105257 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |