MEDICARE: ALEXANDREA WARREN FNP-C, CDE, BC-ADM

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
1	363LF0000X	Family Nurse Practitioner	APRN11016882	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619300753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDREA WARREN FNP-C, CDE, BC-ADM

Provider Business Mailing Address
First Line	:	1241 AIRPORT RD STE M
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32541-2954
Country	:	US
Telephone Number	:	850-460-7090
Fax Number	:	850-460-7093

Provider Business Practice Location Address
First Line	:	5551 US HIGHWAY 98 W
Second Line	:
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-3566
Country	:	US
Telephone Number	:	850-420-5420
Fax Number	:	850-244-8011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2013
Last Update Date	:	03/24/2026

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