1144306887 NPI number — ANNE MARGARET WARREN RN, MS, ANP-BC, ADCN

Table of content: ANNE MARGARET WARREN RN, MS, ANP-BC, ADCN (NPI 1144306887)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144306887 NPI number — ANNE MARGARET WARREN RN, MS, ANP-BC, ADCN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARREN
Provider First Name:
ANNE
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, MS, ANP-BC, ADCN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STEPHEN
Provider Other First Name:
ANNE
Provider Other Middle Name:
MARGARET
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144306887
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
31500 TELEGRAPH RD
Provider Second Line Business Mailing Address:
SUITE 010
Provider Business Mailing Address City Name:
BINGHAM FARMS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48025-4367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-552-0620
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
47601 GRAND RIVER AVE
Provider Second Line Business Practice Location Address:
SUITE 2 SOUTH
Provider Business Practice Location Address City Name:
NOVI
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48374-1233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-552-0620
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  4704150790 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4899560 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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