Healthcare Provider Details

I. General information

NPI: 1487285698
Provider Name (Legal Business Name): CAPRICE WARREN MSN, BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 01/28/2020
Certification Date: 01/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011 ARBUTUS AVE
BALTIMORE MD
21215-5723
US

IV. Provider business mailing address

5011 ARBUTUS AVE
BALTIMORE MD
21215-5723
US

V. Phone/Fax

Practice location:
  • Phone: 410-624-6130
  • Fax:
Mailing address:
  • Phone: 410-624-6130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR202520
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: