Healthcare Provider Details

I. General information

NPI: 1942251442
Provider Name (Legal Business Name): CHERYL BURNETTA WARNER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EVANS ARMY COMMUNITY HOSPITAL 1650 COCHRANE CIR B7500
FT CARSON CO
80913
US

IV. Provider business mailing address

EVANS ARMY COMMUNITY HOSPITAL 1650 COCHRANE CIR B7500
FT CARSON CO
80913
US

V. Phone/Fax

Practice location:
  • Phone: 502-264-5232
  • Fax: 864-654-8027
Mailing address:
  • Phone: 502-264-5232
  • Fax: 864-654-8027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number854
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: