Healthcare Provider Details

I. General information

NPI: 1578704060
Provider Name (Legal Business Name): SALLY WARF RN, CNRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2009
Last Update Date: 03/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6940 CARROLL AVE
TAKOMA PARK MD
20912-4432
US

IV. Provider business mailing address

6940 CARROLL AVE
TAKOMA PARK MD
20912-4432
US

V. Phone/Fax

Practice location:
  • Phone: 301-270-9212
  • Fax: 301-270-9335
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberR174607
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: