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NPI Code Detail

MEDICARE: ANGELA WARREN

MEDICARE:   ANGELA  WARREN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator2103156522NV

General Provider Information

NPI Number : 1053718114
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA WARREN
Provider Business Mailing Address
First Line : 6213 MORNING SPLENDOR WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-1842
Country : US
Telephone Number : 702-502-5775
Fax Number :
Provider Business Practice Location Address
First Line : 6213 MORNING SPLENDOR WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-1842
Country : US
Telephone Number : 702-502-5775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2014
Last Update Date : 12/04/2014

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Directions to “ ANGELA WARREN ” Practice Location

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