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NPI Code Detail

MEDICARE: SHENIDA WARREN LPN

MEDICARE: SHENIDA WARREN LPN
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
1164W00000XLicensed Practical Nurse4703122770MI

General Provider Information

NPI Number : 1780535716
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHENIDA WARREN LPN
Provider Business Mailing Address
First Line : 26845 ANNAPOLIS ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48125-1201
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 43825 MICHIGAN AVE
Second Line :
City : CANTON
State : MI
Zip : 48188-2551
Country : US
Telephone Number : 248-788-9286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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