Healthcare Provider Details

I. General information

NPI: 1356213334
Provider Name (Legal Business Name): NATOSHA RASHIDA WARNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GLENN WARNER

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 MURPHY DR
MIDDLETOWN DE
19709-7503
US

IV. Provider business mailing address

237 MURPHY DR
MIDDLETOWN DE
19709-7503
US

V. Phone/Fax

Practice location:
  • Phone: 866-376-5924
  • Fax:
Mailing address:
  • Phone: 866-376-5924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: