Basic Information
| Provider Information | |||||||||
| NPI: | 1033723903 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WARNER | ||||||||
| FirstName: | SHAWNA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2197 NATIONAL ROAD | ||||||||
| Address2: | |||||||||
| City: | WHEELING | ||||||||
| State: | WV | ||||||||
| PostalCode: | 26003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042331414 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2197 NATIONAL ROAD | ||||||||
| Address2: | |||||||||
| City: | WHEELING | ||||||||
| State: | WV | ||||||||
| PostalCode: | 26003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042331414 | ||||||||
| FaxNumber: | 7402965952 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2020 | ||||||||
| LastUpdateDate: | 10/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3747P1801X | Y | Nursing Service Related Providers | Technician | Personal Care Attendant |
No ID Information.